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General NPI Number Information
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NPI Number | 1356530315
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Entity Type | Organization
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Legal Business Name | MOBILE RADIOLOGY INC
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Dates
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Enumeration Date | 10/16/2007
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Last Update Date | 11/27/2007
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Provider Practice Location Address
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Address Line | 17745 W EXPRESSWAY 83
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City | HARLINGEN
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State | TX
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Zip | 78552-3536
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Country | US
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Telephone | 956-440-9729
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 532844
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City | HARLINGEN
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State | TX
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Zip | 78553-2844
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Country | US
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Telephone | 956-440-9729
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RALPH NIETO
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Credential | R.T.
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Telephone | 956-440-9729
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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 | R23048
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License Number State | TX
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Taxonomy #2
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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 | R23048
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License Number State | TX
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