Organization
FIESTA IMAGING, LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH LAN (ADMINISTRATOR)
(210) 299-7600
Entity
Organization
Contact information
Practice address
8706 FREDERICKSBURG RD STE 103, SAN ANTONIO, TX 78240-1293
(210) 299-7600
(210) 299-7610
Mailing address
8706 FREDERICKSBURG RD STE 103, SAN ANTONIO, TX 78240-1293
(210) 299-7600
(210) 299-7610
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
12/14/2021
Last updated
12/16/2022
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