MEDICARE: EDINBURG RADIOLOGY, LLP

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	174400000X	Specialist	MDG9220	TX

General Provider Information

NPI Number	:	1982827150
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDINBURG RADIOLOGY, LLP

Provider Business Mailing Address
First Line	:	3910 N JACKSON RD
Second Line	:
City	:	PHARR
State	:	TX
Zip	:	78577-7768
Country	:	US
Telephone Number	:	956-928-1882
Fax Number	:	956-928-1866

Provider Business Practice Location Address
First Line	:	3910 N JACKSON RD
Second Line	:
City	:	PHARR
State	:	TX
Zip	:	78577-7768
Country	:	US
Telephone Number	:	956-928-1882
Fax Number	:	956-928-1866

Authorized Official
Title or Position	:	BUSINESS OFFICE MANAGER
Name	:	MS. LYNDA-LEE ESQUIBEL
Credential	:	CMC,CMIS,CMOM
Telephone Number	:	956-928-1882

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	03/22/2016

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