Provider Demographics
NPI:1053334441
Name:TEXARKANA PET/CT IMAGING INSTITUTE, L.P.
Entity Type:Organization
Organization Name:TEXARKANA PET/CT IMAGING INSTITUTE, L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARITA
Authorized Official - Middle Name:L
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-459-3220
Mailing Address - Street 1:4241 VETERANS MEMORIAL BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-5430
Mailing Address - Country:US
Mailing Address - Phone:888-273-3445
Mailing Address - Fax:504-883-5384
Practice Address - Street 1:1929 MOORES LN
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-4612
Practice Address - Country:US
Practice Address - Phone:903-794-1994
Practice Address - Fax:903-794-1996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL05495261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX194123901Medicaid
TXFTN008Medicare PIN
TX194123901Medicaid