Provider Demographics
NPI:1568407617
Name:MCALLEN SOUTH OPEN MRI LP
Entity Type:Organization
Organization Name:MCALLEN SOUTH OPEN MRI LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RUY
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRELES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-688-6740
Mailing Address - Street 1:600 LINDBERG AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-2926
Mailing Address - Country:US
Mailing Address - Phone:956-688-6740
Mailing Address - Fax:956-688-6664
Practice Address - Street 1:600 LINDBERG AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-2926
Practice Address - Country:US
Practice Address - Phone:956-688-6740
Practice Address - Fax:956-688-6664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance ImagingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0880460-01Medicaid
TX0880460-01Medicaid