1255371936 NPI number — HOBBS OPEN MRI LIMITED PARTNERSHIP

Table of content: (NPI 1255371936)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255371936 NPI number — HOBBS OPEN MRI LIMITED PARTNERSHIP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOBBS OPEN MRI LIMITED PARTNERSHIP
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:
HOBBS OPEN MRI
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:
1255371936
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/13/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3900 N. LOVINGTON HIGHWAY, SUITE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOBBS
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
88240
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
575-391-6741
Provider Business Mailing Address Fax Number:
575-391-6742

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3900 N. LOVINGTON HIGHWAY, SUITE 300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOBBS
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
88240
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
575-319-6741
Provider Business Practice Location Address Fax Number:
575-319-6742
Provider Enumeration Date:
06/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NEIDERT
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
S
Authorized Official Title or Position:
MANAGING PARTNER
Authorized Official Telephone Number:
713-922-7247

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)

  • Identifier: NM011A09 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 46024522 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: 186248401 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: NM001A09 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".




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