Provider Demographics
NPI:1497988182
Name:OAKRIDGE DIAGNOSTIC LLC
Entity Type:Organization
Organization Name:OAKRIDGE DIAGNOSTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DELAFLOR WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-592-1115
Mailing Address - Street 1:705 E HOUSTON ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TX
Mailing Address - Zip Code:77327-4630
Mailing Address - Country:US
Mailing Address - Phone:281-592-1115
Mailing Address - Fax:281-592-5988
Practice Address - Street 1:26222 I H 45
Practice Address - Street 2:SUITE A
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-1024
Practice Address - Country:US
Practice Address - Phone:281-292-1310
Practice Address - Fax:281-292-1825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-27
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4767261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty