Provider Demographics
NPI:1124393566
Name:DOX MOBILE RAD L.L.C.
Entity Type:Organization
Organization Name:DOX MOBILE RAD L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:ELIUD
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-763-2328
Mailing Address - Street 1:3414 MOSSY OAK DR
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78542-4384
Mailing Address - Country:US
Mailing Address - Phone:956-763-2328
Mailing Address - Fax:956-682-9167
Practice Address - Street 1:3414 MOSSY OAK DR
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78542-4384
Practice Address - Country:US
Practice Address - Phone:956-763-2328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-19
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile