# COULTER IMAGING CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568408078
- **Authorized official:** MS. ANITA TILDEN (MGR)
- **Authorized official phone:** (806) 358-7149

## Contact information

- **Practice address:** 1900 COULTER ST, UNIT N, AMARILLO, TX 79106-1782
- **Practice address phone:** (806) 358-7149
- **Mailing address:** PO BOX 50420, AMARILLO, TX 79159-0420
- **Mailing address phone:** (806) 358-7149

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | R13716 | TX | Yes |
| 261QR0206X | Mammography Clinic/Center | R13716 | TX | — |

## Other

- **Enumeration date:** 06/22/2006
- **Last updated:** 11/13/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 080601001 | — | TX |
| 01 | — | 103168100 | FIRSTCARE | — |