Organization
SAN MARCOS MRI, LP
Active
Other names
Advanced Imaging San Marcos
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SYD G. VITAL (ADMINISTRATOR)
(512) 353-5535
Entity
Organization
Contact information
Practice address
1330 WONDER WORLD DR, STE 202, SAN MARCOS, TX 78666-7566
(512) 353-5535
(512) 353-7797
Mailing address
1330 WONDER WORLD DR, STE 202, SAN MARCOS, TX 78666-7566
(512) 353-5535
(512) 353-7797
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
R29023
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1724924 01
—
TX
Enumeration date
11/08/2005
Last updated
12/21/2011
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