# VERIZON PORTABLE XRAY SERVICE INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063742211
- **Authorized official:** MR. SAMUEL JAMES OTT I R.T.R (RADIOLOGIC TECHNOLOGIST/OWNER)
- **Authorized official phone:** (806) 240-0965

## Contact information

- **Practice address:** 350 FM 145, EARTH, TX 79031-2110
- **Practice address phone:** (806) 240-0965
- **Mailing address:** 350 FM 145, EARTH, TX 79031-2110
- **Mailing address phone:** (806) 240-0965

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0208X | Mobile Radiology Clinic/Center | — | NULL | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | — |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 01/12/2010
- **Last updated:** 01/12/2010