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General NPI Number Information
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NPI Number | 1336722552
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Entity Type | Organization
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Legal Business Name | HOME X-RAY LLC
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Dates
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Enumeration Date | 05/05/2021
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Last Update Date | 05/05/2021
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Provider Practice Location Address
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Address Line | 8018 OXFORDSHIRE DR
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City | SPRING
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State | TX
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Zip | 77379-4665
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Country | US
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Telephone | 832-946-9729
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Fax | 866-337-6969
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Provider Business Mailing Address
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Address Line | 8018 OXFORDSHIRE DR
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City | SPRING
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State | TX
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Zip | 77379-4665
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Country | US
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Telephone | 832-946-9729
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Fax | 866-337-6969
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Authorized Official
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Title or Position | CEO
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Name | MR. JEFF KENNARD SHEPHERD I
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Credential | RT(R)(CT)
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Telephone | 832-946-9729
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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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