Organization
LAREDO OMI, INC
Active
Other names
Laredo Open MRI
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID T LARSON MD (RADIOLOGIST)
(956) 728-1177
Entity
Organization
Contact information
Practice address
209 W VILLAGE BLVD STE 6, LAREDO, TX 78041-2227
(956) 728-1177
Mailing address
209 W VILLAGE BLVD STE 6, LAREDO, TX 78041-2227
(956) 728-1177
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
723408
MEDICARE
TX
01
—
742836600
TX ID
TX
Enumeration date
10/12/2006
Last updated
06/17/2019
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