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General NPI Number Information
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NPI Number | 1437542818
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Entity Type | Organization
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Legal Business Name | PREFERRED IMAGING OF AUSTIN LLC
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Dates
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Enumeration Date | 03/10/2015
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Last Update Date | 04/06/2022
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Provider Practice Location Address
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Address Line | 711 W 38TH ST SUITE B-1
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City | AUSTIN
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State | TX
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Zip | 78705-1121
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Country | US
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Telephone | 512-420-0000
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Fax | 512-420-0003
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Provider Business Mailing Address
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Address Line | PO BOX 674232
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City | DALLAS
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State | TX
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Zip | 75267-4232
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Country | US
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Telephone | 512-420-0000
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Fax | 512-420-0003
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Authorized Official
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Title or Position | SR VICE PRESIDENT
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Name | LAURA KASSA
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Credential |
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Telephone | 904-515-0362
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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 | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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