Provider Demographics
NPI:1649368903
Name:LAREDO MOLECULAR IMAGING, LTD
Entity type:Organization
Organization Name:LAREDO MOLECULAR IMAGING, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:G
Authorized Official - Last Name:CIGARROA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-725-1228
Mailing Address - Street 1:PO BOX 1698
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78044-1698
Mailing Address - Country:US
Mailing Address - Phone:956-726-0033
Mailing Address - Fax:956-727-5201
Practice Address - Street 1:1710 E. SAUNDERS ST
Practice Address - Street 2:TOWER B 5TH FLOOR
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041
Practice Address - Country:US
Practice Address - Phone:956-726-0033
Practice Address - Fax:956-727-5201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0429DCOtherBC/BS OF TEXAS #
TX0429DCOtherBC/BS OF TEXAS #
TXFTN026Medicare ID - Type UnspecifiedMEDICARE PROVIDER #