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General NPI Number Information
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NPI Number | 1184774663
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Entity Type | Organization
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Legal Business Name | PREMIER DOPPLER IMAGING
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 16601 BLANCO RD 207
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City | SAN ANTONIO
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State | TX
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Zip | 78232-1914
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Country | US
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Telephone | 210-823-7056
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Fax |
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Provider Business Mailing Address
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Address Line | 2327 RUBY OAKS
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City | SAN ANTONIO
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State | TX
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Zip | 78232-5600
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Country | US
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Telephone | 210-823-7056
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. WESLEY JENNINGS
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Credential |
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Telephone | 210-823-7056
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State | TX
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