Premium Mobile X-Rays LLC

Primary specialty

Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X

License

802031012 Issued in TX

Legal business name

PREMIUM MOBILE X-RAYS LLC

Practice address

608 Walnut Bend Dr
Mansfield, TX 76063-5850

Phone

(682) 401-0609

Fax

(866) 301-2005

NPI assigned

Aug 11, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Steven Butler

Title

Founder

Phone

(972) 965-1536

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1407715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407715200000",
    "number": "1831508233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 WALNUT BEND DR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635850",
            "telephone_number": "682-401-0609",
            "fax_number": "866-301-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 WALNUT BEND DR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635850",
            "telephone_number": "682-401-0609",
            "fax_number": "866-301-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM MOBILE X-RAYS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-11",
        "last_updated": "2014-08-11",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "972-965-1536",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "TX",
            "license": "802031012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Mansfield, TX by specialty
• Mobile Radiology Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; 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.