Provider Demographics
NPI:1720637325
Name:RAD X MOBILE IMAGING LLC
Entity Type:Organization
Organization Name:RAD X MOBILE IMAGING LLC
Other - Org Name:RAD X MOBILE IMAGING LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/RADILOGIC TECHNOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ANISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUSENBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:806-603-3434
Mailing Address - Street 1:6923 INDIANA AVE
Mailing Address - Street 2:PMB 258
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79413-6111
Mailing Address - Country:US
Mailing Address - Phone:806-603-3434
Mailing Address - Fax:844-723-9729
Practice Address - Street 1:7409 RALEIGH AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-2303
Practice Address - Country:US
Practice Address - Phone:806-603-3434
Practice Address - Fax:844-723-9729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-05
Last Update Date:2023-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier