Mid County Diagnostics Inc

Primary specialty

Nuclear Radiology PhysicianTaxonomy code 2085N0904X

Legal business name

MID COUNTY DIAGNOSTICS INC

Practice address

2501 Jimmy Johnson Blvd., Suite 500
Port Arthur, TX 77640

Phone

(409) 723-6605

NPI assigned

Jan 29, 2007

Organization subpart

No

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

Authorized official

Name

Srinivasa Rao Kothopalli, M.D.

Title

Owner

Phone

(409) 723-6605

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396881363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 JIMMY JOHNSON BLVD., SUITE 500",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "77640",
            "telephone_number": "409-723-6605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 JIMMY JOHNSON BLVD., SUITE 500",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "77640",
            "telephone_number": "409-723-6605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID COUNTY DIAGNOSTICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOTHOPALLI",
        "authorized_official_first_name": "SRINIVASA",
        "authorized_official_middle_name": "RAO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-723-6605",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Nuclear Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaqueline Medina, DDS
• Luis A Medina
• Gary Roy Mennie, M.D.
• Michael C Percenti, DPM PLLC
• Keely Nicole Michalk, PHARM D, R.PH.
• Mid County Medical Group PA
• Midcounty Family Physicians Associates, LLP
• Mira R Miles Samuel
• Millennium Neonatolgy PLLC
• Millennium Neonatology of Port Arthur PLLC

• Nuclear Radiology Physician in Port Arthur, TX
• Providers in Port Arthur, TX by specialty
• Nuclear 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.