Organization
HORIZON MRI OF SAN ANTONIO WEST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTIN J KERN (SENIOR VICE PRESIDENT)
(941) 925-3490
Entity
Organization
Contact information
Practice address
2140 BABCOCK RD, SAN ANTONIO, TX 78229-4424
(210) 692-0674
(210) 949-1878
Mailing address
240 N WASHINGTON BLVD, SARASOTA, FL 34236-5945
(941) 925-3490
(941) 953-4452
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0343DC
BCBS PROV #
TX
01
—
242744
AMERIGROUP
—
01
—
3537015
AETNA/MEDSOLUTONS -HMO
—
01
—
7126556
AETNA/MEDSOLUTIONS-PPO
—
Enumeration date
05/24/2005
Last updated
08/22/2020
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