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General NPI Number Information
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NPI Number | 1629345707
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Entity Type | Organization
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Legal Business Name | BEN-ORA, HANSEN, & VANESIAN IMAGING
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Dates
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Enumeration Date | 11/17/2011
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Last Update Date | 09/12/2012
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Provider Practice Location Address
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Address Line | 11220 N TATUM BLVD STE 105
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City | PHOENIX
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State | AZ
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Zip | 85028-1629
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Country | US
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Telephone | 602-493-0204
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Fax |
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Provider Business Mailing Address
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Address Line | 15601 DALLAS PKWY SUITE 500
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City | ADDISON
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State | TX
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Zip | 75001-3353
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Country | US
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Telephone | 469-398-4100
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | NATALIE KEHM
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Credential |
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Telephone | 469-398-4100
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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 |
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License Number State |
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