# GULF COAST MOBILE IMAGING

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

## Provider details

- **NPI number:** 1659425544
- **Authorized official:** MRS. DEANNA FASELT VICE PRESIDENT (OWNER)
- **Authorized official phone:** (702) 839-1133

## Contact information

- **Practice address:** 7020 HIGHWAY 190 STE A, COVINGTON, LA 70433-4962
- **Practice address phone:** (337) 594-9637
- **Mailing address:** 2490 PROFESSIONAL CT STE 110, LAS VEGAS, NV 89128-0835
- **Mailing address phone:** (702) 839-1133

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 247100000X | Radiologic Technologist | 088168 | LA | — |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 01/22/2007
- **Last updated:** 06/17/2022