Provider Demographics
NPI:1609982131
Name:OPEN AIR IMAGING CENTER, LLP
Entity Type:Organization
Organization Name:OPEN AIR IMAGING CENTER, LLP
Other - Org Name:ADVANCED IMAGING CENTER OF AMARILLO, LLP
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ALTERNATE AO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:D
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-353-8333
Mailing Address - Street 1:PO BOX 3779
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79116-3779
Mailing Address - Country:US
Mailing Address - Phone:806-353-8333
Mailing Address - Fax:806-353-8333
Practice Address - Street 1:7400 WALLACE BLVD
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1818
Practice Address - Country:US
Practice Address - Phone:806-353-8333
Practice Address - Fax:806-353-8333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Z068Medicare PIN