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General NPI Number Information
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NPI Number | 1861452864
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Entity Type | Organization
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Legal Business Name | CENTRAL TEXAS RADIOLOGICAL ASSOCIATES PA
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 03/06/2017
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Provider Practice Location Address
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Address Line | 6901 MEDICAL PKWY RADIOLOGY DEPARTMENT
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City | WACO
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State | TX
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Zip | 76712-7910
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Country | US
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Telephone | 254-751-4299
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Fax | 903-663-7394
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Provider Business Mailing Address
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Address Line | 3206 4TH ST
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City | LONGVIEW
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State | TX
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Zip | 75605-5143
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Country | US
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Telephone | 903-663-4800
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Fax | 903-663-7394
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Authorized Official
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Title or Position | PARTNER
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Name | KATHLEEN SORENSEN
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Credential | MD
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Telephone | 254-751-4299
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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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