Organization
CENTRAL SAN ANTONIO IMAGING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN K. WISNIEWSKI (CFO)
(210) 208-2147
Entity
Organization
Contact information
Practice address
1303 MCCULLOUGH AVE, SUITE 160, SAN ANTONIO, TX 78212-5609
(210) 208-2147
Mailing address
7418 JOHN SMITH, SUITE 218, SAN ANTONIO, TX 78229-6020
(210) 614-0959
Taxonomy
Speciality
Code
Description
License number
State
207RM1200X
Magnetic Resonance Imaging (MRI) Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00T32Z
BCBS
TX
05
—
085205501
—
TX
01
—
DN6641
MEDICARE RAILROAD
TX
Enumeration date
08/10/2006
Last updated
12/11/2008
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