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General NPI Number Information
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NPI Number | 1518004290
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Entity Type | Organization
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Legal Business Name | BEN-ORA HANSEN & VANESIAN IMAGING LTD
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 1661 E CAMELBACK RD STE 140
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City | PHOENIX
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State | AZ
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Zip | 85016-3957
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Country | US
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Telephone | 602-234-2601
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Fax | 602-234-3183
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Provider Business Mailing Address
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Address Line | PO BOX 738064
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City | DALLAS
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State | TX
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Zip | 75373-8064
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Country | US
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Telephone | 448-260-6151
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GRANT DAVIS
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Credential |
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Telephone | 469-398-4167
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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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