Diagnostic Imaging Associates PA
Organization Active NPI Diagnostic Radiology Physician · Victoria, TX
NPI 1104852664 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1104852664
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- Legal business name
- DIAGNOSTIC IMAGING ASSOCIATES PA
- Practice address
- 506 E San Antonio Street
Victoria, TX 77901 - Phone
- (361) 575-7441
- NPI assigned
- Jun 24, 2006
- Organization subpart
- No
Authorized official
- Name
- Silvestre A Ortiz, MD
- Title
- President
- Phone
- (361) 576-2116
Practitioners 9
-
John Ryan Mikus, M.D.
-
Peter N Agomuo, M.D
-
Madison Kate Hayes, RPA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040721000259 | TX | Part B Supplier - Clinic/Group Practice | 5799765822 |
Receives reassigned benefits from 4 practitioners Practice locations: Victoria, TX; Hallettsville, TX |
National Provider Directory
Locations
1607 N Main St
Victoria, TX 77901
Phone (361) 576-2116
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician |
2085R0202X | Yes |
Addresses
Primary practice location
506 E San Antonio Street
Victoria, TX 77901
Mailing address
1607 N Main Street
Victoria, TX 77901-5213
Phone (361) 576-2116
Other providers in Victoria, TX
- George C Dewey
- Dewitt Medical District
- Yogesh C Dhingra
- Diagnostic Foot Specialists
- Diagnostic Foot Specialists of Victoria Inc
- Eliana Diaz
- Jorge Armando Diaz
- Jorge Eduardo Diaz
- Caitlin Dichiara
- Michael C Dilorenzo
All providers in Victoria, TX · Diagnostic Radiology Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.