Active NPI
Wichita Area Mobile Service
- Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
- Wichita Falls, TX
National Provider Identifier
1891717799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
- License
- 45-X0009901
- Legal business name
- WICHITA AREA MOBILE SERVICE
- Practice address
- 2113 Kell Blvd Ste E
Wichita Falls, TX 76308-1256 - Phone
- (940) 761-2882
- NPI assigned
- Jul 23, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. James E. Fancher
- Title
- Owner
- Phone
- (940) 761-2882
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 335V00000X | 45-X0009901 | TX | Primary |
Addresses
Primary practice location
2113 Kell Blvd Ste E
Wichita Falls, TX 76308-1256
Mailing address
2113 Kell Blvd Ste E
Wichita Falls, TX 76308-1256
Phone (940) 761-2882
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 45X0009901 | Other | TX | PORT. XRAY MCR ID NO. |
| 7102000TX76308 | Other | MI | BCBS OF MICHIGAN |
| 178472001 | Medicaid | TX | |
| 00000MDXO | Other | BCBS OF TEXAS | |
| 000009998 | Other | TX | BCBS OF TEXAS PROVIDER NO |
National Provider Directory
National Provider DirectoryLocations
2113 Kell Blvd
Ste 4
Wichita Falls, TX 76308
Phone (940) 761-2882
2113 Kell Blvd
Ste E
Wichita Falls, TX 76308
Phone (940) 761-2882
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153612800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1214524800000",
"number": "1891717799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2113 KELL BLVD STE E",
"city": "WICHITA FALLS",
"state": "TX",
"postal_code": "763081256",
"telephone_number": "940-761-2882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2113 KELL BLVD STE E",
"city": "WICHITA FALLS",
"state": "TX",
"postal_code": "763081256",
"telephone_number": "940-761-2882"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WICHITA AREA MOBILE SERVICE",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-23",
"last_updated": "2008-06-27",
"status": "A",
"authorized_official_last_name": "FANCHER",
"authorized_official_first_name": "JAMES",
"authorized_official_middle_name": "E.",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "940-761-2882",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "335V00000X",
"taxonomy_group": "",
"desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
"state": "TX",
"license": "45-X0009901",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PORT. XRAY MCR ID NO.",
"identifier": "45X0009901",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MICHIGAN",
"identifier": "7102000TX76308",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "178472001",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF TEXAS",
"identifier": "00000MDXO",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF TEXAS PROVIDER NO",
"identifier": "000009998",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wichita Falls, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.