# MONTICELLO DIAGNOSTIC IMAGING CLEBURNE, LP

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Monticello Diagnostic Imaging of Cleburne
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639893639
- **Authorized official:** CHELSEA MECHELLE HOLDER (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (817) 377-3800

## Contact information

- **Practice address:** 105 N RIDGEWAY CT, CLEBURNE, TX 76033-4180
- **Practice address phone:** (682) 317-9178
- **Mailing address:** 7668 ELDORADO PKWY STE 200, MCKINNEY, TX 75070-5753
- **Mailing address phone:** (817) 377-3800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |
| 261QR0200X | Radiology Clinic/Center | — | NULL | Yes |
| 293D00000X | Physiological Laboratory | — | NULL | — |

## Other

- **Enumeration date:** 10/03/2022
- **Last updated:** 02/10/2025