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General NPI Number Information
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NPI Number | 1629184361
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Entity Type | Organization
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Legal Business Name | OSTEO IMAGING INC
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 09/18/2008
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Provider Practice Location Address
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Address Line | 1201 E SCHUSTER AVE BLDG 1A
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City | EL PASO
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State | TX
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Zip | 79902-4646
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Country | US
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Telephone | 915-545-2273
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Fax | 915-545-2203
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Provider Business Mailing Address
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Address Line | 1201 E SCHUSTER AVE BLDG 1A
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City | EL PASO
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State | TX
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Zip | 79902-4646
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Country | US
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Telephone | 915-545-2273
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Fax | 915-545-2203
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Authorized Official
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Title or Position | CEO
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Name | MS. MARTHA A COOPER
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Credential | MS CDT
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Telephone | 915-545-2273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0206X
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Taxonomy Name | Mammography Clinic/Center
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License Number | R28046 / M00780
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License Number State | TX
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