San Antonio Diagnostic Imaging Inc

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

SAN ANTONIO DIAGNOSTIC IMAGING INC

Practice address

10007 Huebner Rd
Building 2, Suite 204
San Antonio, TX 78240-1640

Phone

(210) 696-0360

Fax

(210) 696-1725

NPI assigned

Aug 25, 2006

Organization subpart

No

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

Authorized official

Name

Debbie Ross

Title

Director of Managed Care

Phone

(281) 772-7749

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433980800000",
    "number": "1912015587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2569",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774972569",
            "telephone_number": "800-249-3478",
            "fax_number": "713-592-6772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10007 HUEBNER RD",
            "address_2": "BUILDING 2, SUITE 204",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401640",
            "telephone_number": "210-696-0360",
            "fax_number": "210-696-1725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN ANTONIO DIAGNOSTIC IMAGING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2015-06-11",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "DIRECTOR OF MANAGED CARE",
        "authorized_official_telephone_number": "281-772-7749"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112643502",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; 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.