Provider Demographics
NPI:1306845961
Name:MOBILE X-RAY OF AUSTIN INC
Entity Type:Organization
Organization Name:MOBILE X-RAY OF AUSTIN INC
Other - Org Name:HEALTH CARE IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AYAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-342-8300
Mailing Address - Street 1:3720 E LA SALLE ST STE 104
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85040-3976
Mailing Address - Country:US
Mailing Address - Phone:480-990-1335
Mailing Address - Fax:480-990-1337
Practice Address - Street 1:4131 SPICEWOOD SPRINGS RD STE N7
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8664
Practice Address - Country:US
Practice Address - Phone:512-342-8300
Practice Address - Fax:512-342-8508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
293D00000X
TX335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
No293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX086072801Medicaid