Organization Active NPI

Victoria Radiology Associates

  • Diagnostic Radiology Physician
  • Victoria, TX
National Provider Identifier
1467461897
Registry record updated Apr 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
VICTORIA RADIOLOGY ASSOCIATES
Practice address
2710 Hospital Dr
Suite 110
Victoria, TX 77901-5743
Phone
(361) 578-0317
Fax
(361) 578-8142
NPI assigned
Aug 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2014

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

Authorized official

Name
Stephen W Tibbitts, M.D.
Title
Partner
Phone
(361) 578-0317

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

2710 Hospital Dr
Suite 110
Victoria, TX 77901-5743

Mailing address

PO Box 3610
Victoria, TX 77903-3610
Phone (361) 578-0317

Other identifiers 3

IdentifierTypeStateIssuer
CP3083OtherRAILROAD MEDICARE
00L943OtherBLUE CROSS
127283301MedicaidTX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398297600000",
    "number": "1467461897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3610",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779033610",
            "telephone_number": "361-578-0317",
            "fax_number": "361-578-8142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 HOSPITAL DR",
            "address_2": "SUITE 110",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015743",
            "telephone_number": "361-578-0317",
            "fax_number": "361-578-8142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORIA RADIOLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2014-04-24",
        "status": "A",
        "authorized_official_last_name": "TIBBITTS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "361-578-0317",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CP3083",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "00L943",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127283301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2014; 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.