Provider Demographics
NPI:1306946157
Name:ACE MOBILE IMAGING CO.
Entity type:Organization
Organization Name:ACE MOBILE IMAGING CO.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:
Authorized Official - Last Name:JAESCHKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-818-0101
Mailing Address - Street 1:6323 SOVEREIGN DR
Mailing Address - Street 2:SUITE 172B
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6323 SOVEREIGN ST
Practice Address - Street 2:SUITE 172B
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5138
Practice Address - Country:US
Practice Address - Phone:210-818-0101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTIN