1881761005 NPI number — COMFORT IMAGE 2, LTD

Table of content: (NPI 1881761005)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881761005 NPI number — COMFORT IMAGE 2, LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMFORT IMAGE 2, LTD
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:
OPEN MRI OF MCALLEN
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:
1881761005
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/03/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4900 N 10TH ST STE F-1
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MCALLEN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78504-2781
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-668-8282
Provider Business Mailing Address Fax Number:
956-668-8181

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4900 N. 1OTH STREET
Provider Second Line Business Practice Location Address:
F1
Provider Business Practice Location Address City Name:
MCALLEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-668-8282
Provider Business Practice Location Address Fax Number:
956-668-8181
Provider Enumeration Date:
11/30/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SALKINDER
Authorized Official First Name:
SONIA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
956-668-8282

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: 470001932 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 088040301 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: FTXCVU1 . This is a "MEDICARE -PTAN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0144DC . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".