Provider Demographics
NPI:1760139034
Name:MYMOBILEXRAY, PLLC
Entity Type:Organization
Organization Name:MYMOBILEXRAY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CMO
Authorized Official - Prefix:
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:
Authorized Official - Last Name:MOYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-309-1310
Mailing Address - Street 1:1400 NORTHGATE LN
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-9558
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1400 NORTHGATE LN
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-9558
Practice Address - Country:US
Practice Address - Phone:956-309-1310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-07
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile