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General NPI Number Information
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NPI Number | 1306100961
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Entity Type | Organization
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Legal Business Name | AKALA IMAGING, LLC
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Dates
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Enumeration Date | 06/28/2012
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Last Update Date | 06/28/2012
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Provider Practice Location Address
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Address Line | 510 W TIDWELL RD RADIOLOGY DEPARTMENT
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City | HOUSTON
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State | TX
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Zip | 77091-4339
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Country | US
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Telephone | 281-618-8616
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Fax | 281-618-8612
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Provider Business Mailing Address
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Address Line | PO BOX 3255
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City | GALVESTON
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State | TX
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Zip | 77552-0255
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Country | US
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Telephone | 409-908-9997
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Fax | 409-908-0240
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. KIRBY B. DELOZIER
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Credential | MD
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Telephone | 409-908-9997
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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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