Healthcare Provider Details

I. General information

NPI: 1013265354
Provider Name (Legal Business Name): MOUNTAIN VIEW RADIOLOGY,PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2012
Last Update Date: 08/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10501 GATEWAY BLVD W STE 140
EL PASO TX
79925-7929
US

IV. Provider business mailing address

PO BOX 220122
EL PASO TX
79913-2122
US

V. Phone/Fax

Practice location:
  • Phone: 915-544-7300
  • Fax: 915-544-7301
Mailing address:
  • Phone: 915-544-7300
  • Fax: 915-544-7301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS D SPERA
Title or Position: PRESIDENT
Credential: MD
Phone: 915-544-7300