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General NPI Number Information
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NPI Number | 1124328166
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Entity Type | Organization
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Legal Business Name | MOBILE CT IMAGING LLC
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Dates
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Enumeration Date | 10/25/2010
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Last Update Date | 03/09/2011
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Provider Practice Location Address
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Address Line | 2114 HALE AVE SUITE C
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City | HARLINGEN
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State | TX
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Zip | 78550-8408
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Country | US
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Telephone | 956-230-0109
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Fax | 800-660-8632
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Provider Business Mailing Address
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Address Line | 2114 HALE AVE SUITE C
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City | HARLINGEN
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State | TX
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Zip | 78550-8408
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Country | US
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Telephone | 956-230-0109
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Fax | 800-660-8632
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Authorized Official
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Title or Position | MANAGER
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Name | MR. ORLANDO RIVERA
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Credential | RT (R) (CT)
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Telephone | 956-230-0109
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number | R 34551
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License Number State | TX
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