Provider Demographics
NPI:1215402201
Name:LER RADIOLOGY LLC
Entity Type:Organization
Organization Name:LER RADIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:DHARMESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-590-0640
Mailing Address - Street 1:9811 KATY FWY STE 1060
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1280
Mailing Address - Country:US
Mailing Address - Phone:713-590-0640
Mailing Address - Fax:
Practice Address - Street 1:7510 MCPHERSON RD STE 101
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6579
Practice Address - Country:US
Practice Address - Phone:956-242-6790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LPH HEALTHCARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-05
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX160193OtherSTATE LICENSE