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General NPI Number Information
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NPI Number | 1427232602
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Entity Type | Organization
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Legal Business Name | NORTH BROWNSVILLE IMAGING CENTER, L.P.
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Dates
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Enumeration Date | 12/24/2007
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Last Update Date | 12/24/2007
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Provider Practice Location Address
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Address Line | 5700 N. BROWNSVILLE EXPRESSWAY 77/87 SUITE 103
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City | BROWNSVILLE
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State | TX
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Zip | 78520
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Country | US
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Telephone | 956-389-1803
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Fax | 956-389-6796
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Provider Business Mailing Address
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Address Line | 5700 N. BROWNSVILLE EXPRESSWAY 77/87 SUITE 103
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City | BROWNSVILLE
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State | TX
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Zip | 78520
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Country | US
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Telephone | 956-389-1803
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Fax | 956-389-6796
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Authorized Official
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Title or Position | CHIEF OF RADIOLOGY
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Name | DR. DANIEL FUENTES
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Credential | M.D.
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Telephone | 956-389-1803
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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 | NULL
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