MEDICARE: TEXAS MOBILE ULTRASOUND SERVICES 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	261QR0208X	Mobile Radiology Clinic/Center

General Provider Information

NPI Number	:	1437384195
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAS MOBILE ULTRASOUND SERVICES LLC

Provider Business Mailing Address
First Line	:	427 W 20TH ST STE 401
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-2430
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	427 W 20TH ST STE 401
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-2430
Country	:	US
Telephone Number	:	832-279-4814
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	BOBBY SALEHI
Credential	:
Telephone Number	:	832-279-4814

Provider Enumeration Date	:	05/26/2009
Last Update Date	:	06/08/2009

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