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General NPI Number Information
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NPI Number | 1871676643
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Entity Type | Organization
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Legal Business Name | AMERICAN DYNAMIC IMAGING LTD
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 02/10/2016
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Provider Practice Location Address
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Address Line | 9627 HUEBNER RD. SUITE 100
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City | SAN ANTONIO
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State | TX
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Zip | 78240-1662
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Country | US
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Telephone | 210-690-3400
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Fax | 210-690-3407
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Provider Business Mailing Address
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Address Line | 797 LONESOME DOVE TRL
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City | HURST
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State | TX
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Zip | 76054-6018
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Country | US
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Telephone | 817-577-7500
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Fax | 817-577-7501
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. GAY G WALTERS
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Credential |
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Telephone | 817-577-7500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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