1003800608 NPI number — ROY ENGLISH, JR.

Table of content: (NPI 1003800608)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003800608 NPI number — ROY ENGLISH, JR.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROY ENGLISH, JR.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
RAINBOW MEDICAL IMAGING CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003800608
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/02/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2020 BABCOCK RD
Provider Second Line Business Mailing Address:
#14
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78229-4443
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-616-0832
Provider Business Mailing Address Fax Number:
210-615-6950

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2020 BABCOCK RD
Provider Second Line Business Practice Location Address:
#14
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78229-4443
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-616-0832
Provider Business Practice Location Address Fax Number:
210-615-6950
Provider Enumeration Date:
09/09/2005

Additional Information

Authorized Official

Authorized Official Last Name:
ENGLISH
Authorized Official First Name:
ROY
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
210-616-0832

Provider Taxonomy Codes

  • Taxonomy code: 2085N0700X , with the licence number:  R15617 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: R15617 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2471M1202X , with the licence number: R15617 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QM1200X , with the licence number: R15617 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 083633003 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 083633001 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 12532700 . This is a "US DEPT OF LABOR W/C" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 006106 . This is a "BLUE CROSS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 196141901 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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