Provider Demographics
NPI:1134527427
Name:REGENCY DIAGNOSTIC MOBILE SOLUTIONS
Entity type:Organization
Organization Name:REGENCY DIAGNOSTIC MOBILE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-392-1813
Mailing Address - Street 1:7306 93RD ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424
Mailing Address - Country:US
Mailing Address - Phone:806-392-1813
Mailing Address - Fax:
Practice Address - Street 1:7306 93RD ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-4938
Practice Address - Country:US
Practice Address - Phone:806-392-1813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-18
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier