MEDICARE: MD BIO SCAN, INC

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	2083P0901X	Public Health & General Preventive Medicine Physician

General Provider Information

NPI Number	:	1447677661
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MD BIO SCAN, INC

Provider Business Mailing Address
First Line	:	3600 N MCCOLL RD STE E
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78501-9166
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3600 N MCCOLL RD STE E
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78501-9166
Country	:	US
Telephone Number	:	956-686-5226
Fax Number	:

Authorized Official
Title or Position	:	VICE-PRESIDENT
Name	:	PAULRAJAN MANOHARAN
Credential	:	M.D.
Telephone Number	:	956-686-5226

Provider Enumeration Date	:	03/26/2014
Last Update Date	:	08/18/2014

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