Provider Demographics
NPI:1033796388
Name:ADVANCED X-PRESS X-RAY, LLC
Entity Type:Organization
Organization Name:ADVANCED X-PRESS X-RAY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LANISA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUIDRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-795-1107
Mailing Address - Street 1:1911 BAGBY ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-8594
Mailing Address - Country:US
Mailing Address - Phone:713-790-1666
Mailing Address - Fax:713-383-4446
Practice Address - Street 1:1911 BAGBY ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8594
Practice Address - Country:US
Practice Address - Phone:713-790-1666
Practice Address - Fax:713-383-4446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
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
TXR47083OtherST LICENSE