Healthcare Provider Details

I. General information

NPI: 1245225028
Provider Name (Legal Business Name): NATIONAL MOBILE X-RAY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2005
Last Update Date: 02/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 DOMINION DRIVE SUITE 112
MORRISVILLE NC
27560
US

IV. Provider business mailing address

2121 LOHMAN'S CROSSING STE 504 PMB 454
LAKEWAY TX
78734-5217
US

V. Phone/Fax

Practice location:
  • Phone: 980-202-5227
  • Fax:
Mailing address:
  • Phone: 980-202-5227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2471C3402X
TaxonomyRadiography Radiologic Technologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number State

VIII. Authorized Official

Name: BRIDGET DUNBAR
Title or Position: COO
Credential:
Phone: 512-673-7552