Healthcare Provider Details

I. General information

NPI: 1770101701
Provider Name (Legal Business Name): CLEAR IMAGING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2020
Last Update Date: 03/16/2022
Certification Date: 03/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 N SONOMA RANCH BLVD STE G
LAS CRUCES NM
88011-7336
US

IV. Provider business mailing address

18 COPPER CREST LN
EL PASO TX
79902-1925
US

V. Phone/Fax

Practice location:
  • Phone: 575-259-3069
  • Fax:
Mailing address:
  • Phone: 469-525-9966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ARTURO DE LA TORRE
Title or Position: OWNER
Credential:
Phone: 470-440-2600