Provider Demographics
NPI:1669525994
Name:S&R DIAGNOSTICS L L C
Entity type:Organization
Organization Name:S&R DIAGNOSTICS L L C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUILAR
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:361-854-9600
Mailing Address - Street 1:4639 CORONA DR
Mailing Address - Street 2:SUITE 71
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-5423
Mailing Address - Country:US
Mailing Address - Phone:361-854-9600
Mailing Address - Fax:361-225-2642
Practice Address - Street 1:4639 CORONA DR
Practice Address - Street 2:SUITE 71
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-5401
Practice Address - Country:US
Practice Address - Phone:361-854-9600
Practice Address - Fax:361-225-2642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTAX ID NUMBER