Provider Demographics
NPI:1609866003
Name:VALLEY RADIOLOGISTS & ASSOCIATES
Entity Type:Organization
Organization Name:VALLEY RADIOLOGISTS & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-421-3041
Mailing Address - Street 1:PO BOX 2109
Mailing Address - Street 2:
Mailing Address - City:SAN BENITO
Mailing Address - State:TX
Mailing Address - Zip Code:78586-0055
Mailing Address - Country:US
Mailing Address - Phone:866-287-3198
Mailing Address - Fax:614-764-9147
Practice Address - Street 1:1717 TREASURE HILLS BLVD
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8912
Practice Address - Country:US
Practice Address - Phone:956-421-3041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-26
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX082282701Medicaid
TX022925401Medicaid
TX082282701Medicaid