Provider Demographics
NPI:1083661862
Name:CEDAR PARK RADIOLOGY L.P.
Entity Type:Organization
Organization Name:CEDAR PARK RADIOLOGY L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-259-8222
Mailing Address - Street 1:715 DISCOVERY BLVD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-2287
Mailing Address - Country:US
Mailing Address - Phone:512-259-8222
Mailing Address - Fax:512-259-8270
Practice Address - Street 1:715 DISCOVERY BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2287
Practice Address - Country:US
Practice Address - Phone:512-259-8222
Practice Address - Fax:512-259-8270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiographyGroup - Single Specialty