# USMD DIAGNOSTIC SERVICES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** USMD HOLDINGS, INC
- **Other names:** USMD Imaging Center at Clearfork
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1366977449
- **Legal business name:** USMD HOLDINGS, INC
- **Authorized official:** DR. RICHARD COLEMAN JOHNSTON M.D. (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (214) 493-4015

## Contact information

- **Practice address:** 5450 CLEARFORK MAIN ST, SUITE 110, FORT WORTH, TX 76109-3559
- **Practice address phone:** (817) 505-0222
- **Practice address fax:** (817) 510-3690
- **Mailing address:** 5450 CLEARFORK MAIN ST, SUITE 110, FORT WORTH, TX 76109-3559
- **Mailing address phone:** (817) 505-0222
- **Mailing address fax:** (817) 510-3690

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | — | — | Yes |
| 293D00000X | Physiological Laboratory | — | — | — |

## Other

- **Enumeration date:** 04/26/2017
- **Last updated:** 05/20/2022