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General NPI Number Information
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NPI Number | 1891223806
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Entity Type | Organization
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Legal Business Name | EMD DIAGNOSTICS LLC
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Dates
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Enumeration Date | 06/02/2017
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Last Update Date | 06/02/2017
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Provider Practice Location Address
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Address Line | 11706 FALLBROOK DR
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City | HOUSTON
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State | TX
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Zip | 77065-3510
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Country | US
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Telephone | 281-955-3399
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Fax | 281-955-3372
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Provider Business Mailing Address
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Address Line | 19106 E AUSTIN BAYOU CT
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City | CYPRESS
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State | TX
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Zip | 77433-0014
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Country | US
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Telephone | 281-955-3399
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Fax | 281-955-3372
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BILLY ADISA AYOOLA
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Credential |
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Telephone | 281-955-3399
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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 | 802712961
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License Number State | TX
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