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General NPI Number Information
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NPI Number | 1336408152
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Entity Type | Organization
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Legal Business Name | MOBILAB DIAGNOSTICS, LLC
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Dates
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Enumeration Date | 05/14/2012
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Last Update Date | 05/14/2012
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Provider Practice Location Address
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Address Line | 5904 S COOPER ST SUITE 104-184
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City | ARLINGTON
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State | TX
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Zip | 76017-4494
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Country | US
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Telephone | 469-831-7111
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Fax | 888-557-1952
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Provider Business Mailing Address
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Address Line | 5904 S COOPER ST SUITE 104-184
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City | ARLINGTON
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State | TX
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Zip | 76017-4494
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Country | US
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Telephone | 469-831-7111
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Fax | 888-557-1952
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | DARRYL EVANS
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Credential |
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Telephone | 469-831-7111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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