Organization
EL PASO IMAGING CONSULTANTS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHETAN S MOORTHY MD (SOLE OWNER)
(915) 861-1013
Entity
Organization
Contact information
Practice address
4845 ALAMEDA AVE, EL PASO, TX 79905-2705
(575) 532-7000
(575) 532-7025
Mailing address
661 S MESA HILLS DR, STE 102, EL PASO, TX 79912-5550
(800) 522-1952
(575) 532-7025
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287947001
—
TX
Enumeration date
07/06/2011
Last updated
08/20/2012
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