Provider Demographics
NPI:1942234992
Name:R.T. PORTABLE X-RAY INC.
Entity Type:Organization
Organization Name:R.T. PORTABLE X-RAY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:H
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RT
Authorized Official - Phone:972-523-6815
Mailing Address - Street 1:2627 WELLS CT
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-6943
Mailing Address - Country:US
Mailing Address - Phone:972-523-6815
Mailing Address - Fax:214-515-9302
Practice Address - Street 1:2627 WELLS CT
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-6943
Practice Address - Country:US
Practice Address - Phone:972-523-6815
Practice Address - Fax:214-515-9302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5810247100000X
335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Single Specialty
No335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX459898OtherBLUE CROSS/ BLUE SHIELD
TX459898OtherBLUE CROSS/ BLUE SHIELD