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General NPI Number Information
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NPI Number | 1740516152
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Entity Type | Organization
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Legal Business Name | DIGIRAD XRAY MOBILE LLC
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Dates
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Enumeration Date | 10/20/2009
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Last Update Date | 10/20/2009
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Provider Practice Location Address
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Address Line | 121 W TYLER AVE
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City | HARLINGEN
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State | TX
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Zip | 78550-6553
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Country | US
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Telephone | 956-365-4365
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Fax | 956-365-4379
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Provider Business Mailing Address
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Address Line | PO BOX 3226
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City | HARLINGEN
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State | TX
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Zip | 78551-3226
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Country | US
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Telephone | 956-365-4365
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Fax | 956-365-4379
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. RALPH EDWARD MARTINEZ
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Credential | ARRT, RT
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Telephone | 956-365-4365
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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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