Provider Demographics
NPI:1043408552
Name:MSTAT IMAGING, LLC
Entity Type:Organization
Organization Name:MSTAT IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:CESAR
Authorized Official - Last Name:MENDOZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-546-7888
Mailing Address - Street 1:PO BOX 2918
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78551-2918
Mailing Address - Country:US
Mailing Address - Phone:956-423-3335
Mailing Address - Fax:956-423-0138
Practice Address - Street 1:864 CENTRAL BLVD
Practice Address - Street 2:SUITE 600
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-7551
Practice Address - Country:US
Practice Address - Phone:956-546-7888
Practice Address - Fax:956-546-7833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology