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Organization

VALLEY PORTABLE CT SCANS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JORGE ORLANDO TREVINO R.T. (R) (ARRT) (PRESIDENT)
(956) 878-9296
Entity
Organization

Contact information

Practice address
1615 E LOEB ST, EDINBURG, TX 78542-0627
(956) 878-9296
(956) 661-8005
Mailing address
1615 E LOEB ST, EDINBURG, TX 78542-0627
(956) 878-9296
(956) 661-8005

Taxonomy

Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
23843
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R34724
DEPT OF STATE HEALTH SERVICE CERTIFICATE OF X RAY REGISTRATION
TX
Enumeration date
01/07/2009
Last updated
02/28/2011
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