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General NPI Number Information
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NPI Number | 1437462108
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Entity Type | Organization
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Legal Business Name | ADVANCE MOBILE IMAGING
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Dates
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Enumeration Date | 07/22/2010
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Last Update Date | 07/22/2010
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Provider Practice Location Address
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Address Line | 2306 WATER WILLOW
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City | WESLACO
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State | TX
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Zip | 78596-7890
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Country | US
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Telephone | 956-631-9729
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Fax | 800-240-0195
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Provider Business Mailing Address
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Address Line | 2306 WATER WILLOW
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City | WESLACO
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State | TX
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Zip | 78596-7890
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Country | US
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Telephone | 956-631-9729
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Fax | 800-240-0195
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Authorized Official
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Title or Position | OWNER
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Name | RAFATH QURAISH
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Credential | M.D.
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Telephone | 956-973-9696
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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 | R34264
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License Number State | TX
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