Healthcare Provider Details

I. General information

NPI: 1407876881
Provider Name (Legal Business Name): LAREDO OPEN MRI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6019 MCPHERSON RD UNIT 8
LAREDO TX
78041
US

IV. Provider business mailing address

22710 EXECUTIVE DR
STERLING VA
20166
US

V. Phone/Fax

Practice location:
  • Phone: 956-723-9400
  • Fax: 956-723-9410
Mailing address:
  • Phone: 703-464-0318
  • Fax: 703-464-0319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. LINDA O CARDUCCI
Title or Position: MANAGING MEMBER
Credential:
Phone: 703-437-8330