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General NPI Number Information
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NPI Number | 1720065170
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Entity Type | Organization
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Legal Business Name | ARA/ST. DAVID'S IMAGING, LP
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Dates
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Enumeration Date | 12/28/2005
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Last Update Date | 07/10/2024
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Provider Practice Location Address
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Address Line | 2120 N MAYS ST SUITE 220
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City | ROUND ROCK
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State | TX
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Zip | 78664-2192
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Country | US
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Telephone | 512-238-7195
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Fax | 512-218-6558
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Provider Business Mailing Address
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Address Line | 12554 RIATA VISTA CIR
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City | AUSTIN
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State | TX
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Zip | 78727-6431
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Country | US
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Telephone | 512-795-5100
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Fax | 512-519-3451
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | SHARLEE LEBLEU
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Credential |
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Telephone | 480-321-7026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | R28983
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License Number State | TX
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