Provider Demographics
NPI:1861639635
Name:LOS ALAMOS IMAGING CENTER LP
Entity type:Organization
Organization Name:LOS ALAMOS IMAGING CENTER LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ISRAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:RT (R)
Authorized Official - Phone:956-792-5270
Mailing Address - Street 1:427 E DURANTA AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMO
Mailing Address - State:TX
Mailing Address - Zip Code:78516-3407
Mailing Address - Country:US
Mailing Address - Phone:956-792-5270
Mailing Address - Fax:956-519-7813
Practice Address - Street 1:427 E DURANTA AVE
Practice Address - Street 2:
Practice Address - City:ALAMO
Practice Address - State:TX
Practice Address - Zip Code:78516-3407
Practice Address - Country:US
Practice Address - Phone:956-792-5270
Practice Address - Fax:956-519-7813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile