MEDICARE: MEDINTEREX LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335V00000X	Portable X-ray and/or Other Portable Diagnostic Imaging Supplier

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	R39899	OTHER	TX	TDHS

General Provider Information

NPI Number	:	1053784868
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDINTEREX LLC

Provider Business Mailing Address
First Line	:	1300 S BRYAN ROAD
Second Line	:	STE. 104
City	:	MISSION
State	:	TX
Zip	:	78572-6688
Country	:	US
Telephone Number	:	956-583-0004
Fax Number	:	956-583-5790

Provider Business Practice Location Address
First Line	:	1400 S ST MARYS ST
Second Line	:
City	:	FALFURRIAS
State	:	TX
Zip	:	78355-5037
Country	:	US
Telephone Number	:	361-233-0077
Fax Number	:	956-790-0468

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. IVAN REMACHE
Credential	:
Telephone Number	:	956-622-5302

Provider Enumeration Date	:	11/03/2015
Last Update Date	:	07/21/2022

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Directions to “MEDINTEREX LLC ” Practice Location

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