=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194820209
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TREASURE HILLS IMAGING LIMITED PARTNERSHIP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/13/2006
-----------------------------------------------------
Last Update Date | 02/01/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1717 TREASURE HILLS BLVD
-----------------------------------------------------
City | HARLINGEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78550-8912
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-389-3300
-----------------------------------------------------
Fax | 956-389-3309
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1717 TREASURE HILLS BLVD
-----------------------------------------------------
City | HARLINGEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78550-8912
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-389-1268
-----------------------------------------------------
Fax | 956-389-4536
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE VP & CFO/COO
-----------------------------------------------------
Name | MR. JAMES E. EASTHAM
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 956-389-1604
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QR0200X
-----------------------------------------------------
Taxonomy Name | Radiology Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------