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General NPI Number Information
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NPI Number | 1578626875
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Entity Type | Organization
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Legal Business Name | SOUTH TEXAS MRI LTD
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 09/09/2010
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Provider Practice Location Address
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Address Line | 7930 FLOYD CURL DR 2ND FLOOR
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3925
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Country | US
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Telephone | 210-617-9850
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Fax | 210-616-7749
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Provider Business Mailing Address
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Address Line | 7930 FLOYD CURL DR FL 2 P. O. BOX 291088
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3925
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Country | US
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Telephone | 210-617-9850
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Fax | 210-616-7749
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Authorized Official
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Title or Position | AGENT
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Name | MR. PHILIP J. RUSSELL
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Credential | CMPE
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Telephone | 210-616-7796
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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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