Provider Demographics
NPI:1609115138
Name:CTOA-CENTRAL TEXAS WOMEN'S IMAGING CENTER, PLLC
Entity Type:Organization
Organization Name:CTOA-CENTRAL TEXAS WOMEN'S IMAGING CENTER, PLLC
Other - Org Name:CENTRAL TEXAS WOMEN'S IMAGING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CENTRAL BUSINESS OFFICE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-279-6707
Mailing Address - Street 1:7718 WOOD HOLLOW DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-1648
Mailing Address - Country:US
Mailing Address - Phone:512-279-6701
Mailing Address - Fax:512-279-6750
Practice Address - Street 1:2220 PARK BEND DR
Practice Address - Street 2:BUILDING 2, SUITE 301
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5387
Practice Address - Country:US
Practice Address - Phone:512-873-7237
Practice Address - Fax:512-837-7237
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL TEXAS OB/GYN ASSOCIATES, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty