Organization Name: | BROAD HORIZON IMAGING, INC. |
NPI Number: | 1053327635 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SHARON D SPENCE (BILLING ADMINISTRATOR) |
Mailing Address: | 1205 N Bedell Ave Del Rio |
State: | TX US |
Postal Code: | 788404163 |
Phone Number: | 8307759563 |
Fax Number: | |
NPI Enumeration Date: | 08/01/2006 |
NPI Last Update Date: | 10/26/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Radiology |
Taxonomy Definition: |