NPIMap

Organization Active NPI

Exevia Diagnostics LLC

  • Diagnostic Radiology Physician
  • Southlake, TX
National Provider Identifier
1093662561
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
EXEVIA DIAGNOSTICS LLC
Practice address
771 E Southlake Blvd Ste 217
Southlake, TX 76092-6989
Phone
(303) 228-6119
NPI assigned
Mar 13, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ani Petrosyan
Title
Owner
Phone
(303) 228-6119

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary
Diagnostic Ultrasound PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085U0001X

Addresses

Primary practice location

771 E Southlake Blvd Ste 217
Southlake, TX 76092-6989

Mailing address

771 E Southlake Blvd Ste 217
Southlake, TX 76092-6989
Phone (303) 228-6119

National Provider Directory

National Provider Directory
Tax ID family
Exevia Diagnostics LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1773360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773360000000",
    "number": "1093662561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "771 E SOUTHLAKE BLVD STE 217",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926989",
            "telephone_number": "303-228-6119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "771 E SOUTHLAKE BLVD STE 217",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926989",
            "telephone_number": "303-228-6119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXEVIA DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-13",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A",
        "authorized_official_last_name": "PETROSYAN",
        "authorized_official_first_name": "ANI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-228-6119"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.