Provider Demographics
NPI:1437320538
Name:L V IMAGING
Entity type:Organization
Organization Name:L V IMAGING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:956-495-8658
Mailing Address - Street 1:1900 N. EXPRESSWAY 77 B-2
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521
Mailing Address - Country:US
Mailing Address - Phone:956-495-8658
Mailing Address - Fax:956-548-1198
Practice Address - Street 1:1900 N. EXPRESSWAY 77 B-2
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521
Practice Address - Country:US
Practice Address - Phone:956-495-8658
Practice Address - Fax:956-548-1198
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:L V IMAGING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-17
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Y073Medicare PIN