Provider Demographics
NPI:1215055744
Name:SCY IMAGING INC
Entity type:Organization
Organization Name:SCY IMAGING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:CURTIS
Authorized Official - Last Name:YELDELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-695-9729
Mailing Address - Street 1:PO BOX 21
Mailing Address - Street 2:
Mailing Address - City:LYONS
Mailing Address - State:TX
Mailing Address - Zip Code:77863-0021
Mailing Address - Country:US
Mailing Address - Phone:979-695-9729
Mailing Address - Fax:800-695-6382
Practice Address - Street 1:2722 OSLER BLVD
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-2517
Practice Address - Country:US
Practice Address - Phone:979-695-9729
Practice Address - Fax:800-695-6382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR24941335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX459884OtherBLUE CROSS BLUE SHIELD
TX630001470OtherRAILROAD MEDICARE
TX109541602Medicaid
TX630001470OtherRAILROAD MEDICARE