Provider Demographics
NPI:1730475153
Name:SANKARARAO TAMTAM, MD, PA
Entity Type:Organization
Organization Name:SANKARARAO TAMTAM, MD, PA
Other - Org Name:SEGUIN IMAGING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANKARARAO
Authorized Official - Middle Name:
Authorized Official - Last Name:TAMTAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-379-1199
Mailing Address - Street 1:936 S HWY 123 BYPASS
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-9756
Mailing Address - Country:US
Mailing Address - Phone:830-379-1199
Mailing Address - Fax:
Practice Address - Street 1:936 S HWY 123 BYPASS
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-9756
Practice Address - Country:US
Practice Address - Phone:830-379-1199
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology