Provider Demographics
NPI:1124328166
Name:MOBILE CT IMAGING LLC
Entity type:Organization
Organization Name:MOBILE CT IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:RT (R) (CT)
Authorized Official - Phone:956-230-0109
Mailing Address - Street 1:2114 HALE AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8408
Mailing Address - Country:US
Mailing Address - Phone:956-230-0109
Mailing Address - Fax:800-660-8632
Practice Address - Street 1:2114 HALE AVE
Practice Address - Street 2:SUITE C
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8408
Practice Address - Country:US
Practice Address - Phone:956-230-0109
Practice Address - Fax:800-660-8632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-25
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR 34551335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier