Provider Demographics
NPI:1083611693
Name:XPRESS RAY, INC.
Entity Type:Organization
Organization Name:XPRESS RAY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:R
Authorized Official - Last Name:ASARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-455-5992
Mailing Address - Street 1:3400 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-4612
Mailing Address - Country:US
Mailing Address - Phone:504-455-5992
Mailing Address - Fax:504-455-5998
Practice Address - Street 1:3400 DIVISION ST
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-4612
Practice Address - Country:US
Practice Address - Phone:504-455-5992
Practice Address - Fax:504-455-5998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA19821335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1968676Medicaid
LA19821Medicare ID - Type UnspecifiedPORTABLE X-RAY PROVIDER