Provider Demographics
NPI:1669516910
Name:DESERT IMAGING SERVICES L P
Entity type:Organization
Organization Name:DESERT IMAGING SERVICES L P
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:IDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOUSTAUNAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-577-0100
Mailing Address - Street 1:118 W CASTELLANO DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-6170
Mailing Address - Country:US
Mailing Address - Phone:915-577-0100
Mailing Address - Fax:915-225-0134
Practice Address - Street 1:122 W CASTELLANO DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-6170
Practice Address - Country:US
Practice Address - Phone:915-577-0100
Practice Address - Fax:915-225-0134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology