Provider Demographics
NPI:1689165961
Name:GEORGETOWN RADIOLOGY ASSOCIATES, PLLC.
Entity Type:Organization
Organization Name:GEORGETOWN RADIOLOGY ASSOCIATES, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER AND RADIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:CALLAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-939-6777
Mailing Address - Street 1:113 TANKSLEY CIR
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-5320
Mailing Address - Country:US
Mailing Address - Phone:409-939-6777
Mailing Address - Fax:
Practice Address - Street 1:113 TANKSLEY CIR
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-5320
Practice Address - Country:US
Practice Address - Phone:409-939-6777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL52672085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty