Vista Pem Providers, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

VISTA PEM PROVIDERS, LLC

Practice address

5072 W Plano Pkwy
Suite 190
Plano, TX 75093-4476

Phone

(972) 479-1115

Fax

(972) 479-1118

NPI assigned

Jun 11, 2010

Organization subpart

No

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

Authorized official

Name

Clerissa Hadley

Title

Director of Network Development

Phone

(972) 215-7410

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516320000000",
    "number": "1225359367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 678282",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752678282",
            "telephone_number": "972-479-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5072 W PLANO PKWY",
            "address_2": "SUITE 190",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750934476",
            "telephone_number": "972-479-1115",
            "fax_number": "972-479-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA PEM PROVIDERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-11",
        "last_updated": "2018-01-19",
        "status": "A",
        "authorized_official_last_name": "HADLEY",
        "authorized_official_first_name": "CLERISSA",
        "authorized_official_title_or_position": "DIRECTOR OF NETWORK DEVELOPMENT",
        "authorized_official_telephone_number": "972-215-7410"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QX0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oncology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Visionworks, Inc.
• Visionworks, Inc.
• Nazneen Visram
• Vista Neurology PLLC
• Vista Ophthalmology Associates, PA
• Vista Pem Providers, LLC
• Gita Viswam, M.D.
• Vita Nova Chiropractic LLC
• Vital Physician House Calls LLC
• Vitalbridge Medical Supply LLC

• Radiology Clinic/Center in Plano, TX
• Providers in Plano, TX by specialty
• Radiology Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2018; 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.