NPI age
19 years
Enumerated 2007-05-23
Across 3776 active radiology providers in Texas.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (IL) | 0361201111 | |
| 05 (MO) | 208746305 | |
| 01 (IL) | R02012 | MEDICARE PTAN |
Part of a multi-provider practice. 244 other active providers share this practice address in NPPES.
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