Healthcare Provider Details

I. General information

NPI: 1821029224
Provider Name (Legal Business Name): CENTRAL TX RADIOLOGY & SPINE CONSULTANTS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 03/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4316 JAMES CASEY ST STE E1
AUSTIN TX
78745-1157
US

IV. Provider business mailing address

PO BOX 164326
AUSTIN TX
78716-4326
US

V. Phone/Fax

Practice location:
  • Phone: 512-306-0648
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SCOTT EUGENE CAMPBELL
Title or Position: RADIOLOGIST
Credential: MD
Phone: 512-306-0648