Organization
MOBILE X-RAY OF AMARILLO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK PAUL BROWN (OWNER/OPERATOR)
(806) 676-8960
Entity
Organization
Contact information
Practice address
4303 SOUTH FANNIN, AMARILLO, TX 79110-0000
(806) 371-6717
Mailing address
4303 S FANNIN ST, AMARILLO, TX 79110-1708
(806) 676-8960
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
12900
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
086093401
—
TX
01
—
630000608
RAILROAD MEDICARE
—
Enumeration date
06/21/2006
Last updated
12/29/2020
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