Provider Demographics
NPI:1609031897
Name:JULIO MORALES MALDONADO
Entity Type:Organization
Organization Name:JULIO MORALES MALDONADO
Other - Org Name:CARDIOGRAPHIC MOBILE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MGR.
Authorized Official - Prefix:MR
Authorized Official - First Name:RODIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-258-5855
Mailing Address - Street 1:PO BOX 301047
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77230-1047
Mailing Address - Country:US
Mailing Address - Phone:713-747-6844
Mailing Address - Fax:713-383-9732
Practice Address - Street 1:2403 NAOMI ST
Practice Address - Street 2:UNIT 12
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-4022
Practice Address - Country:US
Practice Address - Phone:713-661-1996
Practice Address - Fax:713-383-9732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-28
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiographyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFTCVU10Medicare PIN