NPIMap

Organization Active NPI

Modified Barium Swallow Service, P.a.

  • Diagnostic Radiology Physician
  • Tyler, TX
National Provider Identifier
1871594697
Registry record updated Nov 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
L0882 Issued in TX
Legal business name
MODIFIED BARIUM SWALLOW SERVICE, P.A.
Practice address
3724 FM 346 E
Tyler, TX 75703-8340
Phone
(210) 325-6277
Fax
(210) 682-5195
NPI assigned
Aug 2, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2007

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

Authorized official

Name
Dr. Chad Reed Niles, M.D.NPI 1073587788
Title
Medical Director
Phone
(210) 325-6277

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085R0202X L0882 TX Primary

Addresses

Primary practice location

3724 FM 346 E
Tyler, TX 75703-8340

Mailing address

3724 FM 346 E
Tyler, TX 75703-8340
Phone (210) 325-6277

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194393600000",
    "number": "1871594697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3724 FM 346 E",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757038340",
            "telephone_number": "210-325-6277",
            "fax_number": "210-682-5195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3724 FM 346 E",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757038340",
            "telephone_number": "210-325-6277",
            "fax_number": "210-682-5195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODIFIED BARIUM SWALLOW SERVICE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-02",
        "last_updated": "2007-11-07",
        "status": "A",
        "authorized_official_last_name": "NILES",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "REED",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "210-325-6277",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "L0882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; 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.