Basic Information
| Provider Information | |||||||||
| NPI: | 1316449234 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DELIVERRAD PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3170 DOS REALES LOOP | ||||||||
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| City: | LAREDO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 780456543 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9562066971 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1700 E SAUNDERS ST | ||||||||
| Address2: | |||||||||
| City: | LAREDO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 780415474 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9567965000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2018 | ||||||||
| LastUpdateDate: | 04/16/2018 | ||||||||
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| AuthorizedOfficialLastName: | TROUNG | ||||||||
| AuthorizedOfficialFirstName: | VI | ||||||||
| AuthorizedOfficialMiddleName: | Q. | ||||||||
| AuthorizedOfficialTitleorPosition: | AUTHORIZED OFFICIAL | ||||||||
| AuthorizedOfficialTelephone: | 9567965000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.