Provider Demographics
NPI:1396707345
Name:NATIONAL MOBILE X-RAY LLC
Entity type:Organization
Organization Name:NATIONAL MOBILE X-RAY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:BRIDGET
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNBAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-673-7552
Mailing Address - Street 1:2121 LOHMAN'S CROSSING
Mailing Address - Street 2:STE 504 PMB 454
Mailing Address - City:LAKEWAY
Mailing Address - State:TX
Mailing Address - Zip Code:78734-5217
Mailing Address - Country:US
Mailing Address - Phone:980-202-5227
Mailing Address - Fax:
Practice Address - Street 1:6580 VALLEY CENTER DR #302
Practice Address - Street 2:
Practice Address - City:RADFORD
Practice Address - State:VA
Practice Address - Zip Code:24141
Practice Address - Country:US
Practice Address - Phone:980-202-5227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-05
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1336299338Medicaid