Organization
M&S RADIOLOGY ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILLIP FORTENBERRY M.D. (PRESIDENT)
(210) 892-0228
Entity
Organization
Contact information
Practice address
8715 VILLAGE DR STE 320, SAN ANTONIO, TX 78217-5407
(210) 858-8019
(210) 455-0169
Mailing address
DEPT D8288, P O BOX 650002, DALLAS, TX 75265-0282
(800) 666-1816
(706) 653-5917
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164588901
—
TX
Enumeration date
11/03/2005
Last updated
12/20/2022
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