Provider Demographics
NPI:1134944697
Name:MRI CENTERS OF TEXAS LLC- SOUTH SAN ANTONIO SERIES
Entity type:Organization
Organization Name:MRI CENTERS OF TEXAS LLC- SOUTH SAN ANTONIO SERIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-226-1800
Mailing Address - Street 1:PO BOX 224852
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75222-4852
Mailing Address - Country:US
Mailing Address - Phone:817-226-1800
Mailing Address - Fax:817-226-1802
Practice Address - Street 1:94 BRIGGS AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224
Practice Address - Country:US
Practice Address - Phone:817-226-1800
Practice Address - Fax:817-226-1802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology