Organization
IRON HORSE AMIGOS
Active
Other names
ANGELO MRI
Organization subpart
No
Provider details
NPI number
Authorized official
CLINTON REICHENAUS (PARTNER)
(325) 234-8889
Entity
Organization
Contact information
Practice address
4114 S JACKSON STREET, SAN ANGELO, TX 76903-6377
(325) 703-6741
Mailing address
4114 S JACKSON STREET, SAN ANGELO, TX 76903-6377
(325) 703-6741
(325) 703-6742
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
261QR0200X
Radiology Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1036DC
BCBS
TX
Enumeration date
10/13/2017
Last updated
02/21/2018
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