Organization
K&R RAD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY ANN ADDIS M.D. (MANAGING MEMBER)
(210) 687-1483
Entity
Organization
Contact information
Practice address
8902 FLOYD CURL DR, LIFECARE HOSPITAL - RADIOLOGY DEPARTMENT, SAN ANTONIO, TX 78240-1681
(210) 690-7000
Mailing address
4777 US HIGHWAY 259, LONGVIEW, TX 75605-7668
(903) 663-8663
(903) 663-0378
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
M1446
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
UNASSIGNED
APPLYING FOR FIRST TIME
—
Enumeration date
07/23/2010
Last updated
07/23/2010
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