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General NPI Number Information
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NPI Number | 1497988182
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Entity Type | Organization
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Legal Business Name | OAKRIDGE DIAGNOSTIC LLC
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Dates
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Enumeration Date | 08/27/2009
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Last Update Date | 02/18/2014
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Provider Practice Location Address
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Address Line | 26222 I H 45 SUITE A
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City | SPRING
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State | TX
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Zip | 77386-1024
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Country | US
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Telephone | 281-292-1310
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Fax | 281-292-1825
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Provider Business Mailing Address
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Address Line | 705 E HOUSTON ST
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City | CLEVELAND
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State | TX
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Zip | 77327-4630
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Country | US
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Telephone | 281-592-1115
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Fax | 281-592-5988
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. RAFAEL DELAFLOR WEISS
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Credential | M.D.
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Telephone | 281-592-1115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | J4767
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License Number State | TX
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