Provider Demographics
NPI:1518180033
Name:RADIOLOGY IMAGING OF SOUTH TEXAS
Entity Type:Organization
Organization Name:RADIOLOGY IMAGING OF SOUTH TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-853-4503
Mailing Address - Street 1:3226 REID DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-2519
Mailing Address - Country:US
Mailing Address - Phone:361-853-4503
Mailing Address - Fax:
Practice Address - Street 1:3226 REID DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2519
Practice Address - Country:US
Practice Address - Phone:361-853-4503
Practice Address - Fax:361-853-4454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital