MEDICARE: RAWLINGS B TANYI

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	R37095	TX

General Provider Information

NPI Number	:	1962718361
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAWLINGS B TANYI

Provider Business Mailing Address
First Line	:	110 W RANDOL MILL RD
Second Line	:	STE 228
City	:	ARLINGTON
State	:	TX
Zip	:	76011-4611
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 W RANDOL MILL RD
Second Line	:	STE 228
City	:	ARLINGTON
State	:	TX
Zip	:	76011-4611
Country	:	US
Telephone Number	:	855-214-5620
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RAWLINGS B TANYI
Credential	:	ARRT, RT (R)
Telephone Number	:	800-540-5000

Provider Enumeration Date	:	08/23/2010
Last Update Date	:	05/31/2013

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