Provider Demographics
NPI:1497912109
Name:CLARITYMD, LLC
Entity Type:Organization
Organization Name:CLARITYMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:RELIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-826-1245
Mailing Address - Street 1:3104 LATING STREAM LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-2004
Mailing Address - Country:US
Mailing Address - Phone:512-826-1245
Mailing Address - Fax:
Practice Address - Street 1:3104 LATING STREAM LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-2004
Practice Address - Country:US
Practice Address - Phone:512-826-1245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR17143335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier