Provider Demographics
NPI:1285930388
Name:WEBB COUNTY IMAGING, LLC
Entity type:Organization
Organization Name:WEBB COUNTY IMAGING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:N
Authorized Official - Last Name:LIGHTNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-726-0501
Mailing Address - Street 1:9802 MCPHERSON RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-6413
Mailing Address - Country:US
Mailing Address - Phone:956-726-0501
Mailing Address - Fax:956-726-6361
Practice Address - Street 1:9802 MCPHERSON RD
Practice Address - Street 2:SUITE 108
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-6413
Practice Address - Country:US
Practice Address - Phone:956-726-0501
Practice Address - Fax:956-726-6361
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAREDO URGENT CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-02-07
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR32972247100000X
TXR32972R2471M1202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Single Specialty
No2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance ImagingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0780DCOtherBCBS OF TEXAS