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General NPI Number Information
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NPI Number | 1124822648
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Entity Type | Organization
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Legal Business Name | X MOBILE X RAY INC
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Dates
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Enumeration Date | 04/03/2025
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 762 E ANGELICA ST
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City | SOMERTON
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State | AZ
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Zip | 85350
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Country | US
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Telephone | 928-285-7857
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3818
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City | SOMERTON
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State | AZ
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Zip | 85350-3818
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Country | US
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Telephone | 928-285-7857
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SAMUEL PUENTES
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Credential |
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Telephone | 928-285-7857
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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 |
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License Number State |
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