1699728139 NPI number — E PLUS PET IMAGING II LP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699728139 NPI number — E PLUS PET IMAGING II LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
E PLUS PET IMAGING II LP
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:
1699728139
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/16/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2493A S BRAESWOOD BLVD
Provider Second Line Business Mailing Address:
KIRBY GLENN CENTER
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77030-4332
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-200-2828
Provider Business Mailing Address Fax Number:
832-200-2829

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2493A S BRAESWOOD BLVD
Provider Second Line Business Practice Location Address:
KIRBY GLENN CENTER
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77030-4332
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-200-2828
Provider Business Practice Location Address Fax Number:
832-200-2829
Provider Enumeration Date:
05/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RHYMER
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
Authorized Official Title or Position:
COO OF GENERAL PARTNER
Authorized Official Telephone Number:
615-467-7415

Provider Taxonomy Codes

  • Taxonomy code: 261QR0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: P00093361 . This is a "RRMEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0310DC . This is a "BLUE CROSS/BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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