Healthcare Provider Details

I. General information

NPI: 1932055480
Provider Name (Legal Business Name): AETHER DIAGNOSTIC IMAGING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2026
Last Update Date: 03/07/2026
Certification Date: 03/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 W ALBERTSON DR
HOBBS NM
88240-1929
US

IV. Provider business mailing address

123 W ALBERTSON DR
HOBBS NM
88240-1929
US

V. Phone/Fax

Practice location:
  • Phone: 575-631-7179
  • Fax:
Mailing address:
  • Phone: 575-631-7179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AMARAH LYLES
Title or Position: DIAGNOSTIC MEDICAL SONOGRAPHER
Credential: RDMS, RVT
Phone: 575-631-7179