Healthcare Provider Details

I. General information

NPI: 1235771205
Provider Name (Legal Business Name): AKUMIN IMAGING TEXAS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2019
Last Update Date: 02/20/2020
Certification Date: 02/20/2020
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

7920 BELT LINE RD STE 900
DALLAS TX
75254-8198
US

V. Phone/Fax

Practice location:
  • Phone: 915-544-7300
  • Fax:
Mailing address:
  • Phone:
  • 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: LAURA KASSA
Title or Position: SR VICE PRESIDENT
Credential:
Phone: 904-610-4653