Organization
MRS.GRACIELA TERESA NIETO
Active
Other names
Medical X-Ray on Wheels
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GRACIELA TERESA NIETO (OWNER)
(956) 535-2818
Entity
Organization
Contact information
Practice address
1405 E LYON ST, LAREDO, TX 78040-2733
(956) 722-9729
(956) 722-9990
Mailing address
PO BOX 1886, HARLINGEN, TX 78551-1886
(956) 722-9729
(956) 722-9990
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
R29718
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
185111501
—
TX
Enumeration date
04/15/2008
Last updated
02/13/2017
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