Provider Demographics
NPI:1407929219
Name:RADIOLOGY PROFESSIONAL SOLUTIONS, PC
Entity Type:Organization
Organization Name:RADIOLOGY PROFESSIONAL SOLUTIONS, PC
Other - Org Name:RADIOLOGY 24/7
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANDIP
Authorized Official - Middle Name:A
Authorized Official - Last Name:PATIDAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:866-972-9247
Mailing Address - Street 1:PO BOX 463
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79105-0463
Mailing Address - Country:US
Mailing Address - Phone:866-972-9247
Mailing Address - Fax:
Practice Address - Street 1:5820 OBERLIN DR.
Practice Address - Street 2:SUITE 205
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-3743
Practice Address - Country:US
Practice Address - Phone:866-972-9247
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL46352085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCOA100254Medicare PIN
NVBZ099AMedicare PIN
OKOKB5928Medicare PIN
LA5DN29Medicare PIN
FLDG666AMedicare PIN
CABZ099BMedicare PIN