# RAYTEL NUCLEAR IMAGING - FORT WORTH, L.P.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538115340
- **Authorized official:** MR. JEFFREY M. FLANEGIN (PRESIDENT)
- **Authorized official phone:** (610) 831-1112

## Contact information

- **Practice address:** 1650 W ROSEDALE ST, SUITE 206, FORT WORTH, TX 76104-7400
- **Practice address phone:** (817) 348-8813
- **Practice address fax:** (817) 877-4103
- **Mailing address:** 7 WATERSIDE XING, 3RD FLOOR ATTN: KAREN FRISK, CONTRACTING, WINDSOR, CT 06095-1540
- **Mailing address phone:** (800) 367-1095
- **Mailing address fax:** (860) 298-6127

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | L04659 | TX | Yes |

## Other

- **Enumeration date:** 05/25/2006
- **Last updated:** 08/31/2007