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General NPI Number Information
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NPI Number | 1528680378
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Entity Type | Organization
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Legal Business Name | SOUTH TEXAS RDI GROUP LLC
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Dates
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Enumeration Date | 05/15/2020
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Last Update Date | 05/15/2020
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Provider Practice Location Address
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Address Line | 6630 FM 1463 RD STE 500-134
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City | KATY
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State | TX
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Zip | 77494-7412
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Country | US
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Telephone | 281-850-5325
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Fax |
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Provider Business Mailing Address
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Address Line | 5006 WATERBECK ST
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City | WESTON LAKES
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State | TX
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Zip | 77441-4143
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Country | US
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Telephone | 281-850-5325
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | AVERY OBLEPIAS
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Credential | RRT
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Telephone | 281-850-5325
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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 |
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License Number State |
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