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General NPI Number Information
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NPI Number | 1467786947
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Entity Type | Organization
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Legal Business Name | PLEXUS MOBILE DIAGNOSTICS
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Dates
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Enumeration Date | 09/30/2009
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Last Update Date | 05/27/2010
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Provider Practice Location Address
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Address Line | 14506 OLD TYBEE RD.
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City | HOUSTON
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State | TX
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Zip | 77084
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Country | US
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Telephone | 979-571-5812
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 842416
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City | HOUSTON
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State | TX
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Zip | 77284
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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 | MANAGER
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Name | WESLEY ALLEN CAMPBELL
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Credential |
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Telephone | 979-571-5812
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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