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General NPI Number Information
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NPI Number | 1992938005
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Entity Type | Organization
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Legal Business Name | WTR SERVICES LLC
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Dates
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Enumeration Date | 08/24/2009
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Last Update Date | 10/30/2009
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Provider Practice Location Address
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Address Line | 620 REED ST
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City | ROANOKE
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State | TX
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Zip | 76262-6644
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Country | US
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Telephone | 817-896-1390
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2255
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City | ROANOKE
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State | TX
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Zip | 76262-2255
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Country | US
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Telephone | 817-896-1390
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMEBER
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Name | ROBERT J. HOOPER
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Credential |
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Telephone | 940-453-3567
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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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