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General NPI Number Information
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NPI Number | 1285961201
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Entity Type | Organization
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Legal Business Name | ACCURATE VASCULAR DIAGNOSTIC CENTER, LLC
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Dates
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Enumeration Date | 11/12/2009
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Last Update Date | 02/25/2011
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Provider Practice Location Address
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Address Line | 1801 S 5TH ST SUITE 208
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City | MCALLEN
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State | TX
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Zip | 78503-2927
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Country | US
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Telephone | 956-994-9193
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 S MCCOLL RD SUITE B, PMB 163
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City | MCALLEN
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State | TX
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Zip | 78503-1501
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Country | US
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Telephone | 956-994-9193
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATIVE DIRECTOR
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Name | MR. WALLY REYNALDO PRADO
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Credential | RVT
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Telephone | 956-994-9193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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