Provider Demographics
NPI:1275687428
Name:WELLSCAN IMAGING LLC
Entity Type:Organization
Organization Name:WELLSCAN IMAGING LLC
Other - Org Name:MCALLEN NORTH IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:VALENCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-668-0702
Mailing Address - Street 1:5030 NORTH 10TH ST.
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2832
Mailing Address - Country:US
Mailing Address - Phone:956-668-0702
Mailing Address - Fax:956-682-6108
Practice Address - Street 1:5030 NORTH 10TH ST.
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2832
Practice Address - Country:US
Practice Address - Phone:956-668-0702
Practice Address - Fax:956-682-6108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR260242471C3401X
293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes293D00000XLaboratoriesPhysiological Laboratory
No2471C3401XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistComputed TomographyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX143335101Medicaid
TXP00320397OtherMEDICARE RR
TX218DCOtherBLUE CROSS BLUE SHIELD
TXP00320397OtherMEDICARE RR