Healthcare Provider Details

I. General information

NPI: 1700860681
Provider Name (Legal Business Name): EPIRAD INC.,
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 SE OSCEOLA ST STE. 2
STUART FL
34994-2504
US

IV. Provider business mailing address

4400 COUNTRY CLUB DR
DICKINSON TX
77539-7620
US

V. Phone/Fax

Practice location:
  • Phone: 772-463-2346
  • Fax: 772-463-2310
Mailing address:
  • Phone: 281-337-3423
  • Fax: 281-337-2611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0203X
TaxonomyRadiation Oncology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. RONALD HARLAN WOODY
Title or Position: PRESIDENT
Credential: M.D.,
Phone: 772-463-2346