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General NPI Number Information
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NPI Number | 1396629010
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Entity Type | Organization
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Legal Business Name | QUICK SHOT DIAGNOSTIC LLC
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 506 SUMMER ACRES CT
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City | ROSENBERG
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State | TX
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Zip | 77469-4613
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Country | US
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Telephone | 281-202-8657
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Fax |
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Provider Business Mailing Address
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Address Line | 506 SUMMER ACRES CT
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City | ROSENBERG
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State | TX
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Zip | 77469-4613
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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 | DIRECTOR
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Name | LEO DELA ROSA
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Credential |
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Telephone | 281-788-3334
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 247100000X
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Taxonomy Name | Radiologic Technologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2471C3402X
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Taxonomy Name | Radiography Radiologic Technologist
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License Number |
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License Number State |
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Taxonomy #4
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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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