1730418880 NPI number — SOLIS WOMEN'S HEALTH BREAST IMAGING SPECIALISTS OF INDIANA, PC

Table of content: MR. RICHARD DAVID ROJAS DDS (NPI 1528136462)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730418880 NPI number — SOLIS WOMEN'S HEALTH BREAST IMAGING SPECIALISTS OF INDIANA, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOLIS WOMEN'S HEALTH BREAST IMAGING SPECIALISTS OF INDIANA, PC
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:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
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Provider Other Name Suffix Text:
Provider Other Credential Text:
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NPI Number Information

NPI Number:
1730418880
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/09/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15601 DALLAS PARKWAY
Provider Second Line Business Mailing Address:
SUITE 500
Provider Business Mailing Address City Name:
ADDISON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75001-6021
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
469-398-4100
Provider Business Mailing Address Fax Number:
469-398-4189

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11450 NORTH MERIDIAN STREET
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
CARMEL
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46032
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-872-3583
Provider Business Practice Location Address Fax Number:
317-844-2893
Provider Enumeration Date:
12/21/2009

Additional Information

Authorized Official

Authorized Official Last Name:
KEHM
Authorized Official First Name:
NATALIE
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGING EMPLOYEE
Authorized Official Telephone Number:
469-398-4110

Provider Taxonomy Codes

  • Taxonomy code: 261QR0206X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 201031120A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




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