Organization
RANEK, LC
Active
Other names
The Imaging Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHIE HALEY (OPERATIONS MANAGER)
(936) 462-9909
Entity
Organization
Contact information
Practice address
4932 NORTH ST, NACOGDOCHES, TX 75965-1878
(936) 462-9909
(936) 462-8528
Mailing address
PO BOX 632067, NACOGDOCHES, TX 75963-2067
(936) 462-9909
(936) 462-8528
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0433DC
BLUECROSS BLUESHIELD
TX
05
—
1718710-01
—
TX
01
—
P00249391
RAILROAD MEICARE
—
Enumeration date
04/20/2006
Last updated
05/12/2008
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