Healthcare Provider Details

I. General information

NPI: 1104874510
Provider Name (Legal Business Name): HAYSVILLE DIAGNOSTIC CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 N TYLER RD STE. # 114
WICHITA KS
67212-4916
US

IV. Provider business mailing address

2020 N. TYLER RD STE. # 114
WICHITA KS
67212
US

V. Phone/Fax

Practice location:
  • Phone: 316-491-2093
  • Fax: 316-491-2097
Mailing address:
  • Phone: 316-491-2093
  • Fax: 316-491-2097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR0206X
TaxonomyMammography Clinic/Center
License Number236167
License Number StateKS

VIII. Authorized Official

Name: DR. DANIEL ALVAREZ
Title or Position: PRESIDENT
Credential: D.O.
Phone: 316-491-2093