Provider Demographics
NPI:1386959740
Name:MCALLEN REGIONAL IMAGING LLC
Entity type:Organization
Organization Name:MCALLEN REGIONAL IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRELLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-687-6747
Mailing Address - Street 1:1801 S 5TH ST
Mailing Address - Street 2:STE. 107
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-2927
Mailing Address - Country:US
Mailing Address - Phone:956-687-6747
Mailing Address - Fax:956-687-6740
Practice Address - Street 1:1801 S 5TH ST
Practice Address - Street 2:STE. 107
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-2927
Practice Address - Country:US
Practice Address - Phone:956-687-6747
Practice Address - Fax:956-687-6740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX230536261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)