# IDEAL MRI, LLC

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

## Provider details

- **NPI number:** 1932692548
- **Authorized official:** CARL MILLER MD (PRESIDENT)
- **Authorized official phone:** (734) 657-3868

## Contact information

- **Practice address:** 2816 MARKETPLACE DR STE 120, WACO, TX 76711-2487
- **Practice address phone:** (833) 433-2567
- **Practice address fax:** (903) 663-9960
- **Mailing address:** 3206 4TH ST, LONGVIEW, TX 75605-5143
- **Mailing address phone:** (903) 663-4800
- **Mailing address fax:** (903) 663-9960

## Taxonomy

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

## Other

- **Enumeration date:** 06/08/2018
- **Last updated:** 12/27/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 390647101 | — | TX |