MEDICARE: ARA/ST. DAVID'S IMAGING, LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0200X	Radiology Clinic/Center	R28983	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00198486	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225015530
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARA/ST. DAVID'S IMAGING, LP

Provider Business Mailing Address
First Line	:	12554 RIATA VISTA CIR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78727-6431
Country	:	US
Telephone Number	:	512-795-5100
Fax Number	:	512-519-3451

Provider Business Practice Location Address
First Line	:	1701 W BEN WHITE BLVD
Second Line	:	SUITE 170
City	:	AUSTIN
State	:	TX
Zip	:	78704-7667
Country	:	US
Telephone Number	:	512-428-9090
Fax Number	:	512-428-9864

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	SHARLEE LEBLEU
Credential	:
Telephone Number	:	480-321-7026

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	07/10/2024

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Directions to “ARA/ST. DAVID'S IMAGING, LP ” Practice Location

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