OrganizationActive
Elite View Imaging LLC
NPI 1649643602 · Diagnostic Neuroimaging (Radiology) Physician · Phoenix, AZ
Provider details
- NPI number
- 1649643602
- Entity type
- Organization
- Primary specialty
- Diagnostic Neuroimaging (Radiology) PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Stephen Broussard, President
- License
- OTC5077 (AZ)
Practice location
1110 E Missouri Ave
Suite 140
Phoenix, AZ 85014-2707
Phone: (602) 274-4674
Fax: (602) 274-6060
Mailing address
Po Box 857
Coppell, TX 75019-0857
Registry dates
- Enumerated
- 2015-11-12
- Last updated
- 2015-11-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.