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General NPI Number Information
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NPI Number | 1477864718
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Entity Type | Organization
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Legal Business Name | VALLEY ANGELS MOBILE IMAGING, LLC.
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Dates
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Enumeration Date | 07/01/2010
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Last Update Date | 08/16/2010
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Provider Practice Location Address
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Address Line | 5250 RIDGELINE DR
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City | BROWNSVILLE
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State | TX
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Zip | 78526-3882
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Country | US
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Telephone | 956-533-4152
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Fax | 956-542-4152
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Provider Business Mailing Address
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Address Line | 5250 RIDGELINE DR
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City | BROWNSVILLE
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State | TX
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Zip | 78526-3882
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Country | US
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Telephone | 956-533-4152
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Fax | 956-542-4152
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | SAMUEL CHONG
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Credential |
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Telephone | 956-533-4152
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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 | TX
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Taxonomy #2
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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 | TX
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