CORINTH PET IMAGING, LP , NPI 1528179652 — CORINTH (TX)

NPI 1528179652

13+ Years Experience Organization

CORINTH PET IMAGING, LP

08/31/2006
PROVIDER ENUMERATION DATE
07.08.2007
LAST UPDATE DATE
1528179652
NPI NUMBER

About CORINTH PET IMAGING, LP

CORINTH PET IMAGING, LP is a provider established in CORINTH, TX. The NPI number of CORINTH PET IMAGING, LP is 1528179652 and was assigned on 08/31/2006. The practitioners primary taxonomy code is: 261QR0200X .

Mailing address

  • City: CORINTH
  • State: TX
  • Postal code: 762102348
  • Phone: 9402705000
  • Fax: 9402695001
  • Address: 4851 S INTERSTATE 35 E STE 101

Primary Practice Address

  • Region : CORINTH, TX
  • NPI : 1528179652
  • Phone : 9402705000
  • Fax : 9402695001
  • Postalcode : 762102348
  • Address : 4851 S INTERSTATE 35 E STE 101

Provider taxonomy - Clinic/Center

  • Taxonomy code: 261QR0200X

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Contacts:

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  • CORINTH PET IMAGING, LP
  • Address : 4851 S INTERSTATE 35 E STE 101
  • Region : CORINTH, TX
  • NPI : 1528179652
  • Phone : 9402705000
  • Fax : 9402695001
  • Postalcode : 762102348

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 9402705000
  • Title or position : PARTNER
  • Credentials : MD

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address4851 S INTERSTATE 35 E STE 101
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameCORINTH
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameTX
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code762102348
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number9402705000
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number9402695001
The fax number associated with the location address of the provider being identified.
NPI1528179652
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1261QR0200X
Provider Enumeration Date08/31/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated07.08.2007
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)CORINTH PET IMAGING, LP
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address4851 S INTERSTATE 35 E STE 101
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameCORINTH
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameTX
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code762102348
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number9402705000
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number9402695001
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Authorized Official Last NameCAMPBELL
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameODETTE
The first name of the authorized official
Authorized Official Middle NameLOUISE
The middle name of the authorized official
Authorized Official Title or PositionPARTNER
The title or position of the authorized official
Authorized Official Name Prefix TextDR.
Authorized Official Name Prefix Text
Authorized Official Credential TextMD
Authorized Official Credential Text
Authorized Official Telephone Number9402705000
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #1261QR0200X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Clinic/Center
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
X

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