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General NPI Number Information
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NPI Number | 1518928787
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Entity Type | Organization
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Legal Business Name | AUSTIN POSITRON EMISSION TOMOGRAPHY
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Dates
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Enumeration Date | 03/29/2006
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Last Update Date | 01/31/2008
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Provider Practice Location Address
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Address Line | 11044 RESEARCH BLVD SUITE D100
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City | AUSTIN
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State | TX
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Zip | 78759-5263
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Country | US
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Telephone | 512-340-0963
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Fax |
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Provider Business Mailing Address
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Address Line | 11044 RESEARCH BLVD SUITE D100
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City | AUSTIN
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State | TX
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Zip | 78759-5263
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Country | US
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Telephone | 512-340-0963
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Fax |
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | CHUCK PETERSON
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Credential |
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Telephone | 512-340-0963
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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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