Provider Demographics
NPI:1427065572
Name:LAREDO MRI & IMAGING CENTER, LLC
Entity type:Organization
Organization Name:LAREDO MRI & IMAGING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:NEWTON
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:STE 108
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-6413
Mailing Address - Country:US
Mailing Address - Phone:956-753-0800
Mailing Address - Fax:
Practice Address - Street 1:9802 MCPHERSON RD
Practice Address - Street 2:STE 108
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-6413
Practice Address - Country:US
Practice Address - Phone:956-753-0800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR27389247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX26KKOtherBCBS
TXFTX120Medicare ID - Type Unspecified