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Organization
FORT WORTH I ENTERPRISES, LLC
Active
Organization
FORT WORTH I ENTERPRISES, LLC
Active
Other names
Healthy Images of Texas
Organization subpart
No
Provider details
NPI number
Authorized official
GARY BLAKE (MANAGING MEMBER)
(817) 832-3654
Entity
Organization
Contact information
Practice address
4150 INTERNATIONAL PLZ, SUITE 624, FORT WORTH, TX 76109-4892
(817) 349-4408
(817) 349-4409
Mailing address
4150 INTERNATIONAL PLZ, SUITE 624, FORT WORTH, TX 76109-4892
(817) 349-4408
(817) 349-4409
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
NULL
Other
Enumeration date
09/24/2007
Last updated
09/24/2007
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