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General NPI Number Information
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NPI Number | 1003420779
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Entity Type | Organization
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Legal Business Name | MILLENNIUM RADIOLOGY INC
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Dates
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Enumeration Date | 09/01/2020
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Last Update Date | 09/01/2020
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Provider Practice Location Address
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Address Line | 9123 OSAGE VLY
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City | SAN ANTONIO
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State | TX
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Zip | 78251-1739
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Country | US
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Telephone | 210-979-1921
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Fax |
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Provider Business Mailing Address
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Address Line | 9123 OSAGE VLY
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City | SAN ANTONIO
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State | TX
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Zip | 78251-1739
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO
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Name | RUDY MONTEZ
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Credential |
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Telephone | 210-979-1921
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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