National Provider Identifier Database

PRIVIA MEDICAL GROUP WEST TEXAS PLLC
Radiography Radiologic Technologist

A radiologic technologist who specializes in radiography (also known as x-rays) and is appropriately educated and trained, consistent with nationally recognized standards, state statute, and facility policy in performance of radiographs, exam techniques, equipment protocols, radiation safety, and patient care.


Contact Information

PRIVIA MEDICAL GROUP WEST TEXAS, PLLC
1665 ANTILLEY RD
SUITE 200
ABILENE, TX79606-5265
Phone: 325-437-8655
Fax: 325-437-8647
Website:
Specialty Taxonomy Code
* Radiography Radiologic Technologist 2471C3402X

* Indicates primary specialty

NPI Profile & details for PRIVIA MEDICAL GROUP WEST TEXAS, PLLC

NPI Number 1356341184
Legal business name
LBN
PRIVIA MEDICAL GROUP WEST TEXAS, PLLC
Authorized official ANDREW KOUBA - (CEO/AUTHORIZED OFFICIAL)
Entity Organization
Organization subpart No
Enumeration date 07/22/2005
Last updated 04/04/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers
  • TX License #: R2280

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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