Organization
MISSION DIAGNOSTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROXANNA LAROQUE (MANAGER CLIENT EXPERIENCE CONTRACTS)
(210) 598-2801
Entity
Organization
Contact information
Practice address
2915 W BITTERS RD STE 201, SAN ANTONIO, TX 78248-2007
(210) 598-4277
Mailing address
2915 W BITTERS RD STE 201, SAN ANTONIO, TX 78248-2007
(210) 598-4277
Taxonomy
Speciality
Code
Description
License number
State
2084D0003X
Diagnostic Neuroimaging (Psychiatry & Neurology) Physician
—
—
2084N0400X
Neurology Physician
—
—
2084N0600X
Clinical Neurophysiology Physician
—
—
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
—
—
Other
Enumeration date
06/15/2017
Last updated
01/17/2024
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