Provider Demographics
NPI:1982827150
Name:EDINBURG RADIOLOGY, LLP
Entity Type:Organization
Organization Name:EDINBURG RADIOLOGY, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNDA-LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:ESQUIBEL
Authorized Official - Suffix:
Authorized Official - Credentials:CMC,CMIS,CMOM
Authorized Official - Phone:956-928-1882
Mailing Address - Street 1:3910 N JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-7768
Mailing Address - Country:US
Mailing Address - Phone:956-928-1882
Mailing Address - Fax:956-928-1866
Practice Address - Street 1:3910 N JACKSON RD
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-7768
Practice Address - Country:US
Practice Address - Phone:956-928-1882
Practice Address - Fax:956-928-1866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMDG9220174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00083HMedicare ID - Type UnspecifiedPROVIDER NUMBER