Provider Demographics
NPI:1639392533
Name:EL PASO VINTON DIAGNOSTIC PA
Entity Type:Organization
Organization Name:EL PASO VINTON DIAGNOSTIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HERAMB
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-886-4488
Mailing Address - Street 1:7930 DONIPHAN RD
Mailing Address - Street 2:
Mailing Address - City:VINTON
Mailing Address - State:TX
Mailing Address - Zip Code:79821
Mailing Address - Country:US
Mailing Address - Phone:915-886-4488
Mailing Address - Fax:915-886-4688
Practice Address - Street 1:7930 DONIPHAN RD
Practice Address - Street 2:
Practice Address - City:VINTON
Practice Address - State:TX
Practice Address - Zip Code:79821
Practice Address - Country:US
Practice Address - Phone:915-886-4488
Practice Address - Fax:915-886-4688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1984338-01Medicaid
TXDN6856OtherMEDICARE RAILROAD
TX1984338-01Medicaid
TX00Z514Medicare PIN