Provider Demographics
NPI:1174975817
Name:KERRVILLE IMAGING LLC
Entity type:Organization
Organization Name:KERRVILLE IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:T
Authorized Official - Last Name:CHRISTENBERRY
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:813-284-3004
Mailing Address - Street 1:710 HILL COUNTRY DR
Mailing Address - Street 2:STE 2
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-6167
Mailing Address - Country:US
Mailing Address - Phone:830-792-8843
Mailing Address - Fax:607-324-7615
Practice Address - Street 1:710 HILL COUNTRY DR
Practice Address - Street 2:STE 2
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-6167
Practice Address - Country:US
Practice Address - Phone:830-792-8843
Practice Address - Fax:831-895-0514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-06
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)