METHODIST DIAGNOSTIC IMAGING NPI 1013914613

NPI Information

NPI: 1013914613
Provider Name: METHODIST DIAGNOSTIC IMAGING

Doing Business As: COVENANT DIAGNOSTIC IMAGING

Classification: Clinic/Center - 261QR0200X
Entity Type: Organization

Specialization: Radiology

Address:
3525 19TH ST
LUBBOCK, TX
ZIP 79410
Phone: (806) 792-2767
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METHODIST DIAGNOSTIC IMAGING is a radiology clinic center in Lubbock, TX. METHODIST DIAGNOSTIC IMAGING NPI is 1013914613. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Covenant Diagnostic Imaging.

The provider's business location address is:

3525 19TH ST
LUBBOCK, TX
ZIP 79410-202
Phone: (806) 792-2767
Fax: (806) 791-6709

The provider's authorized official is Monty Medanich .
The authorized official title is Coo and has the following contact phone number (806) 792-2767.

The enumeration date for this NPI number is 6/29/2005 and was last updated on 11/3/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085B0100X	Radiology	Body Imaging	N/A	TEXAS	No
2	293D00000X	Physiological Laboratory		N/A	TEXAS	No
3	261QR0200X	Clinic/Center	Radiology	N/A	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	121741603	OTHER	TEXAS	CROSSOVERMEDICAID
2	103173100	OTHER	TEXAS	FIRSTCARE
3	G7966	MEDICAID	NEW MEXICO
4	OOF91Y	OTHER	TEXAS	BLUE CROSS
5	DN6474	OTHER		RAILROAD MEDICARE
6	121741601	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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