Organization
MID COUNTY DIAGNOSTICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SRINIVASA RAO KOTHOPALLI M.D. (OWNER)
(409) 723-6605
Entity
Organization
Contact information
Practice address
2501 JIMMY JOHNSON BLVD., SUITE 500, PORT ARTHUR, TX 77640
(409) 723-6605
Mailing address
2501 JIMMY JOHNSON BLVD., SUITE 500, PORT ARTHUR, TX 77640
(409) 723-6605
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
Primary
—
—
Other
Enumeration date
01/29/2007
Last updated
08/22/2020
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