MEDICARE: NATIONAL MOBILE X-RAY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2471C3402X	Radiography Radiologic Technologist
2	335V00000X	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00077237	OTHER	NC	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245225028
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL MOBILE X-RAY

Provider Business Mailing Address
First Line	:	2121 LOHMAN'S CROSSING
Second Line	:	STE 504 PMB 454
City	:	LAKEWAY
State	:	TX
Zip	:	78734-5217
Country	:	US
Telephone Number	:	980-202-5227
Fax Number	:

Provider Business Practice Location Address
First Line	:	251 DOMINION DRIVE SUITE 112
Second Line	:
City	:	MORRISVILLE
State	:	NC
Zip	:	27560
Country	:	US
Telephone Number	:	980-202-5227
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	BRIDGET DUNBAR
Credential	:
Telephone Number	:	512-673-7552

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	02/26/2019

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Directions to “NATIONAL MOBILE X-RAY ” Practice Location

Language	Start Address	Practice Location

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