Provider Demographics
NPI:1467743468
Name:ASTRO X-RAY, LLC
Entity Type:Organization
Organization Name:ASTRO X-RAY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LEON
Authorized Official - Middle Name:E
Authorized Official - Last Name:HRNCIR
Authorized Official - Suffix:III
Authorized Official - Credentials:CEO
Authorized Official - Phone:512-844-4759
Mailing Address - Street 1:337 POENISCH DR.
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78412
Mailing Address - Country:US
Mailing Address - Phone:512-844-4759
Mailing Address - Fax:361-881-9202
Practice Address - Street 1:337 POENISCH DR.
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412
Practice Address - Country:US
Practice Address - Phone:512-844-4759
Practice Address - Fax:361-881-9202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-25
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3924242335V00000X
TX29570335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier