Provider Demographics
NPI:1801172978
Name:DERWIN EMIL BIOS
Entity type:Organization
Organization Name:DERWIN EMIL BIOS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DERWIN
Authorized Official - Middle Name:EMIL
Authorized Official - Last Name:BIOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-557-1745
Mailing Address - Street 1:524 MEADOWLARK ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWAY
Mailing Address - State:TX
Mailing Address - Zip Code:78734-5313
Mailing Address - Country:US
Mailing Address - Phone:512-557-1745
Mailing Address - Fax:
Practice Address - Street 1:524 MEADOWLARK ST
Practice Address - Street 2:
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78734-5313
Practice Address - Country:US
Practice Address - Phone:512-557-1745
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-02
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2471V0105X, 261QR0208X
943482471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
No2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular SonographyGroup - Multi-Specialty
No2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonographyGroup - Multi-Specialty