# PROFESSIONAL RADIOLOGY PLLC

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

## Provider details

- **NPI number:** 1861918815
- **Authorized official:** DR. JORGE LUIS SARMIENTO (CEO/MD)
- **Authorized official phone:** (915) 225-2480

## Contact information

- **Practice address:** 10501 GATEWAY BLVD W STE 101, EL PASO, TX 79925-7929
- **Practice address phone:** (915) 225-2480
- **Practice address fax:** (915) 315-2481
- **Mailing address:** 10501 GATEWAY BLVD W STE 101, EL PASO, TX 79925-7929
- **Mailing address phone:** (915) 225-2480
- **Mailing address fax:** (915) 315-2481

## Taxonomy

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

## Other

- **Enumeration date:** 08/21/2017
- **Last updated:** 10/28/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3765729001 | — | TX |
| 01 | — | 598796 | MEDICARE | — |