Provider Demographics
NPI:1730079419
Name:RADIANCE DIAGNOSTICS LLC
Entity type:Organization
Organization Name:RADIANCE DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:512-937-2513
Mailing Address - Street 1:2601 SCOFIELD RIDGE PKWY APT 1624
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-6333
Mailing Address - Country:US
Mailing Address - Phone:737-240-2357
Mailing Address - Fax:
Practice Address - Street 1:1005 CONGRESS AVE STE 925-E66
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-2463
Practice Address - Country:US
Practice Address - Phone:512-937-2513
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care