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General NPI Number Information
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NPI Number | 1457603151
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Entity Type | Organization
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Legal Business Name | RELIANCE MOBILE DIAGNOSTICS, LLC
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Dates
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Enumeration Date | 10/05/2012
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Last Update Date | 10/05/2012
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Provider Practice Location Address
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Address Line | 1666 N HAMPTON RD 105
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City | DESOTO
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State | TX
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Zip | 75115-2390
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Country | US
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Telephone | 972-841-1113
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Fax | 214-666-9862
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Provider Business Mailing Address
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Address Line | 1666 N HAMPTON RD 105
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City | DESOTO
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State | TX
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Zip | 75115-2390
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Country | US
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Telephone | 972-841-1113
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Fax | 214-666-9862
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Authorized Official
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Title or Position | ADMINISTRATOR/OWNER
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Name | MR. SAI K RAVI
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Credential |
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Telephone | 972-841-1113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #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 |
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License Number State |
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