Provider Demographics
NPI:1356924047
Name:SAN ANTONIO IMAGING, LTD
Entity type:Organization
Organization Name:SAN ANTONIO IMAGING, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-858-3068
Mailing Address - Street 1:4900 N 10TH ST STE F1
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2781
Mailing Address - Country:US
Mailing Address - Phone:956-668-8282
Mailing Address - Fax:
Practice Address - Street 1:16530 HUEBNER RD STE 401
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78248-1699
Practice Address - Country:US
Practice Address - Phone:210-858-3068
Practice Address - Fax:210-858-3069
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMFORT IMAGE 2, LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)