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General NPI Number Information
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NPI Number | 1023689957
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Entity Type | Organization
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Legal Business Name | CLEAR CORE IMAGING CENTERS
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Dates
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Enumeration Date | 07/01/2021
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Last Update Date | 09/20/2022
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Provider Practice Location Address
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Address Line | 4515 N LOOP 1604 W STE 101
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City | SAN ANTONIO
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State | TX
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Zip | 78249-4588
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Country | US
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Telephone | 832-418-3463
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Fax |
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Provider Business Mailing Address
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Address Line | 609 W SUMMIT AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78212-2741
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Country | US
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Telephone | 832-418-3463
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. DARIAN G PADUA
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Credential |
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Telephone | 832-418-3463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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