Healthcare Provider Details

I. General information

NPI: 1083611693
Provider Name (Legal Business Name): XPRESS RAY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 DIVISION ST
METAIRIE LA
70002-4612
US

IV. Provider business mailing address

3400 DIVISION ST
METAIRIE LA
70002-4612
US

V. Phone/Fax

Practice location:
  • Phone: 504-455-5992
  • Fax: 504-455-5998
Mailing address:
  • Phone: 504-455-5992
  • Fax: 504-455-5998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number19821
License Number StateLA

VIII. Authorized Official

Name: MR. EDWARD R. ASARO
Title or Position: PRESIDENT
Credential:
Phone: 504-455-5992