Portable Diagnostic Services Inc.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

K9889 Issued in TX

Legal business name

PORTABLE DIAGNOSTIC SERVICES INC.

Practice address

3022 Motley Dr Ste 100
Mesquite, TX 75150-3440

Phone

(214) 368-0101

Fax

(972) 613-0546

NPI assigned

Jan 3, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Varghese Raju, M.A.B.ED.

Title

Operation Director-Owner

Phone

(214) 368-0101

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Member of 1

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

• Diagnostic Image Plus

  • Diagnostic Radiology Physician
  • Mesquite, TX
  • NPI 1689781130

  Member Of

  NPD member

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Diagnostic Image Plus

  • Diagnostic Radiology Physician
  • Mesquite, TX
  • NPI 1689781130

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649337965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740732",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753740732",
            "telephone_number": "214-368-0101",
            "fax_number": "972-613-0546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3022 MOTLEY DR STE 100",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751503440",
            "telephone_number": "214-368-0101",
            "fax_number": "972-613-0546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTABLE DIAGNOSTIC SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RAJU",
        "authorized_official_first_name": "VARGHESE",
        "authorized_official_title_or_position": "OPERATION DIRECTOR-OWNER",
        "authorized_official_telephone_number": "214-368-0101",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.A.B.ED."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "K9889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Diagnostic Radiology Physician in Mesquite, TX
• Providers in Mesquite, 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.