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General NPI Number Information
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NPI Number | 1295842847
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Entity Type | Organization
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Legal Business Name | SOUTH LAREDO IMAGING CENTER
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3527 LOOP 20 STE 104
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City | LAREDO
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State | TX
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Zip | 78043-4788
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Country | US
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Telephone | 956-723-1045
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Fax |
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Provider Business Mailing Address
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Address Line | 3527 LOOP 20 STE 104
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City | LAREDO
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State | TX
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Zip | 78043-4788
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | MR. ISRAEL SILVA
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Credential | R.T. (R)
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Telephone | 956-723-1045
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State | TX
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