Provider Demographics
NPI:1487706065
Name:E PLUS PET IMAGING XXIII LP
Entity type:Organization
Organization Name:E PLUS PET IMAGING XXIII LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY OF GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:M
Authorized Official - Last Name:EYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-467-7408
Mailing Address - Street 1:8611 VILLIAGE DRIVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217
Mailing Address - Country:US
Mailing Address - Phone:210-646-0800
Mailing Address - Fax:210-646-0808
Practice Address - Street 1:8611 VILLIAGE DRIVE
Practice Address - Street 2:SUITE 150
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217
Practice Address - Country:US
Practice Address - Phone:210-646-0800
Practice Address - Fax:210-646-0808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology