Provider Demographics
NPI:1447578778
Name:DEL NORTE IMAGING LLC
Entity Type:Organization
Organization Name:DEL NORTE IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BORREGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-595-8815
Mailing Address - Street 1:3130 N LEE TREVINO DR
Mailing Address - Street 2:SUITE 114
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-2060
Mailing Address - Country:US
Mailing Address - Phone:915-595-8815
Mailing Address - Fax:915-595-1058
Practice Address - Street 1:3130 N LEE TREVINO DR
Practice Address - Street 2:SUITE 114
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-2060
Practice Address - Country:US
Practice Address - Phone:915-595-8815
Practice Address - Fax:915-595-1058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-11
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM1200X, 261QR0208X
TXM3476261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile