Provider Demographics
NPI:1114112877
Name:LAGUNA GROUP HOLDINGS LIMITED LIABILITY COMPANY
Entity Type:Organization
Organization Name:LAGUNA GROUP HOLDINGS LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-541-9797
Mailing Address - Street 1:PO BOX 6266
Mailing Address - Street 2:864 CENTRAL BLVD. STE. 200
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78523-6266
Mailing Address - Country:US
Mailing Address - Phone:956-541-9797
Mailing Address - Fax:956-541-9393
Practice Address - Street 1:864 CENTRAL BLVD
Practice Address - Street 2:STE. 200
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-7551
Practice Address - Country:US
Practice Address - Phone:956-541-9797
Practice Address - Fax:956-541-9393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)