Provider Demographics
NPI:1780748475
Name:HOPE DIAGNSOTIC IMAGING CENTER
Entity type:Organization
Organization Name:HOPE DIAGNSOTIC IMAGING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:VERDIGUEL
Authorized Official - Suffix:
Authorized Official - Credentials:BACHELOR OF SCIENCE
Authorized Official - Phone:956-423-3420
Mailing Address - Street 1:2202 S 77 SUNSHINE STRIP STE E
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8332
Mailing Address - Country:US
Mailing Address - Phone:956-423-3420
Mailing Address - Fax:956-423-3423
Practice Address - Street 1:2202 S 77 SUNSHINE STRIP STE E
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8332
Practice Address - Country:US
Practice Address - Phone:956-423-3420
Practice Address - Fax:956-423-3423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFTNX12Medicare PIN