Provider Demographics
NPI:1437861952
Name:HATO TEJAS X RAYS LLC
Entity Type:Organization
Organization Name:HATO TEJAS X RAYS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:PAOLA
Authorized Official - Middle Name:M
Authorized Official - Last Name:RIVERA-HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-476-7356
Mailing Address - Street 1:PO BOX 3310
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00958-0310
Mailing Address - Country:US
Mailing Address - Phone:787-476-7356
Mailing Address - Fax:787-787-1940
Practice Address - Street 1:CALLE 47 BLOQUE 54 #8 SIERRA BAYAMON
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-476-7356
Practice Address - Fax:787-787-1940
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HATO TEJAS X RAYS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology