Provider Demographics
NPI:1205083862
Name:TEXRAY IMAGING SERVICES LLC
Entity type:Organization
Organization Name:TEXRAY IMAGING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:RT(R)
Authorized Official - Phone:281-620-1457
Mailing Address - Street 1:67 WILDFLOWER TRACE PL
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-1540
Mailing Address - Country:US
Mailing Address - Phone:281-620-1457
Mailing Address - Fax:281-419-3477
Practice Address - Street 1:67 WILDFLOWER TRACE PL
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77382-1540
Practice Address - Country:US
Practice Address - Phone:281-620-1457
Practice Address - Fax:281-419-3477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-25
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX91385335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier