Provider Demographics
NPI:1629400650
Name:ALCALA INNOVATION CO
Entity Type:Organization
Organization Name:ALCALA INNOVATION CO
Other - Org Name:XR IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:CESAR
Authorized Official - Last Name:ALCALA
Authorized Official - Suffix:
Authorized Official - Credentials:RT R ARRT
Authorized Official - Phone:915-422-8684
Mailing Address - Street 1:10921 PELLICANO DR STE 124
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-4604
Mailing Address - Country:US
Mailing Address - Phone:915-613-2748
Mailing Address - Fax:915-845-9753
Practice Address - Street 1:10921 PELLICANO DR STE 102
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-4604
Practice Address - Country:US
Practice Address - Phone:915-613-2748
Practice Address - Fax:915-845-9753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR41413261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX91707OtherTEXAS DEPARTMENT OF STATE HEALTH SERVICES
TX399545OtherTHE AMERICANREGITRY OF RADIOLOGIC TECHNOLOGISTS