Provider Demographics
NPI:1225015530
Name:ARA/ST. DAVID'S IMAGING, LP
Entity Type:Organization
Organization Name:ARA/ST. DAVID'S IMAGING, LP
Other - Org Name:ARA IMAGING
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:M
Authorized Official - Last Name:HARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-218-9368
Mailing Address - Street 1:12554 RIATA VISTA CIR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-6431
Mailing Address - Country:US
Mailing Address - Phone:512-795-5100
Mailing Address - Fax:512-519-3451
Practice Address - Street 1:1701 W BEN WHITE BLVD
Practice Address - Street 2:SUITE 170
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7667
Practice Address - Country:US
Practice Address - Phone:512-428-9090
Practice Address - Fax:512-428-9864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-28
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR28983261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX170887701Medicaid
TXP00198486OtherRAILROAD MEDICARE
TXFTA087Medicare PIN