Healthcare Provider Details

I. General information

NPI: 1437320538
Provider Name (Legal Business Name): L V IMAGING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2008
Last Update Date: 03/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 N. EXPRESSWAY 77 B-2
BROWNSVILLE TX
78521
US

IV. Provider business mailing address

1900 N. EXPRESSWAY 77 B-2
BROWNSVILLE TX
78521
US

V. Phone/Fax

Practice location:
  • Phone: 956-495-8658
  • Fax: 956-548-1198
Mailing address:
  • Phone: 956-495-8658
  • Fax: 956-548-1198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RICARDO MENDEZ
Title or Position: OWNER
Credential: PA
Phone: 956-495-8658