Healthcare Provider Details

I. General information

NPI: 1295999837
Provider Name (Legal Business Name): RAD READY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2008
Last Update Date: 12/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 W OCEAN DRIVE
LOS FRESNOS TX
78566-3637
US

IV. Provider business mailing address

101 N STUART PLACE SUITE B PMB 20
HARLINGEN TX
78522-6482
US

V. Phone/Fax

Practice location:
  • Phone: 956-357-0089
  • Fax: 956-233-3407
Mailing address:
  • Phone: 956-357-0089
  • Fax: 956-233-3407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License NumberR31766
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License NumberR31766
License Number StateTX

VIII. Authorized Official

Name: WAYNE WANG
Title or Position: MEMBER
Credential:
Phone: 956-356-0089