Healthcare Provider Details

I. General information

NPI: 1487706065
Provider Name (Legal Business Name): E PLUS PET IMAGING XXIII LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8611 VILLIAGE DRIVE SUITE 150
SAN ANTONIO TX
78217
US

IV. Provider business mailing address

8611 VILLIAGE DRIVE SUITE 150
SAN ANTONIO TX
78217
US

V. Phone/Fax

Practice location:
  • Phone: 210-646-0800
  • Fax: 210-646-0808
Mailing address:
  • Phone: 210-646-0800
  • Fax: 210-646-0808

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: JERRY M. EYLER
Title or Position: SECRETARY OF GENERAL PARTNER
Credential:
Phone: 615-467-7408