Community Portable X-Ray, LLC

Primary specialty

Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X

Legal business name

COMMUNITY PORTABLE X-RAY, LLC

Practice address

1635 Dorchester Dr
Plano, TX 75075-6443

Phone

(972) 633-9427

Fax

(972) 881-1250

NPI assigned

Aug 19, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jason Roeder

Title

Cfo

Phone

(303) 371-0073

Specialties & licenses 2

Addresses

Other identifiers 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• New Schryver LLC

  dba TridentCare

  • Clinical Medical Laboratory
  • Carrollton, TX
  • NPI 1689025116

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455235200000",
    "number": "1396850632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39931",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802390931",
            "telephone_number": "303-371-0073",
            "fax_number": "303-576-7986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 DORCHESTER DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750756443",
            "telephone_number": "972-633-9427",
            "fax_number": "972-881-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY PORTABLE X-RAY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2016-02-12",
        "status": "A",
        "authorized_official_last_name": "ROEDER",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "303-371-0073",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143330202",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Plano, TX
• Providers in Plano, TX by specialty
• Portable X-ray and/or Other Portable Diagnostic Imaging Supplier in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2016; 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.