Healthcare Provider Details

I. General information

NPI: 1538491113
Provider Name (Legal Business Name): LOST PINES MOBILE IMAGING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2010
Last Update Date: 01/20/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4337 LINDBERGH DR
ADDISON TX
75001-4539
US

IV. Provider business mailing address

2101 SHANNON OXMOOR RD # 67
SHANNON AL
35142-2000
US

V. Phone/Fax

Practice location:
  • Phone: 972-224-1329
  • Fax:
Mailing address:
  • Phone: 888-212-4243
  • Fax: 205-847-5262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SAI K RAVI
Title or Position: OWNER
Credential:
Phone: 972-841-1113