MEDICARE: MOBILE DIAGNOSTICS

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1699423178
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBILE DIAGNOSTICS

Provider Business Mailing Address
First Line	:	9706 CHIPSTEAD CT
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-6593
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9706 CHIPSTEAD CT
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-6593
Country	:	US
Telephone Number	:	985-413-2182
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JESTIN MAJOR
Credential	:
Telephone Number	:	985-413-2182

Provider Enumeration Date	:	03/14/2022
Last Update Date	:	03/14/2022

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Directions to “MOBILE DIAGNOSTICS ” Practice Location

Language	Start Address	Practice Location

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