Ic Imaging of Brownsville LLC

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

G9769 Issued in CA

Legal business name

IC IMAGING OF BROWNSVILLE LLC

Practice address

155 B Uptown Ave
Brownsville, TX 78520

Phone

(956) 739-1886

Fax

(956) 546-5201

NPI assigned

Oct 12, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

William R Martin, MD

Title

Medical Director

Phone

(856) 631-0124

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013006121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 B UPTOWN AVE",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "78520",
            "telephone_number": "956-739-1886",
            "fax_number": "956-546-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 B UPTOWN AVE",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "78520",
            "telephone_number": "956-739-1886",
            "fax_number": "956-546-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IC IMAGING OF BROWNSVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "856-631-0124",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G9769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Diagnostic Radiology Physician in Brownsville, TX
• Providers in Brownsville, TX by specialty
• Diagnostic Radiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.