Provider Demographics
NPI:1437462108
Name:ADVANCE MOBILE IMAGING
Entity Type:Organization
Organization Name:ADVANCE MOBILE IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAFATH
Authorized Official - Middle Name:
Authorized Official - Last Name:QURAISH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-973-9696
Mailing Address - Street 1:2306 WATER WILLOW
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-7890
Mailing Address - Country:US
Mailing Address - Phone:956-631-9729
Mailing Address - Fax:800-240-0195
Practice Address - Street 1:2306 WATER WILLOW
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-7890
Practice Address - Country:US
Practice Address - Phone:956-631-9729
Practice Address - Fax:800-240-0195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR34264335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier