1225297278 NPI number — A1 IMAGING OF SAN ANTONIO LLC

Table of content: DR. DICKY LHADEN AIKAT M.D. (NPI 1740434802)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225297278 NPI number — A1 IMAGING OF SAN ANTONIO LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A1 IMAGING OF SAN ANTONIO LLC
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:
Provider Other Organization Name Type Code:
6
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:
1225297278
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/04/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 N TAMIAMI TRL
Provider Second Line Business Mailing Address:
SUITE 800
Provider Business Mailing Address City Name:
SARASOTA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34236-5574
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
941-925-3490
Provider Business Mailing Address Fax Number:
941-953-4452

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
109 GALLERY CIR
Provider Second Line Business Practice Location Address:
SUITE 115
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78258-3327
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-545-3674
Provider Business Practice Location Address Fax Number:
210-545-3691
Provider Enumeration Date:
06/05/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BABITZ
Authorized Official First Name:
ALAN
Authorized Official Middle Name:
Authorized Official Title or Position:
SENIOR VICE PRESIDENT
Authorized Official Telephone Number:
949-336-4336

Provider Taxonomy Codes

  • Taxonomy code: 261QM1200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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