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Organization
GED MEDICAL MANAGEMENT INC
Active
Organization
GED MEDICAL MANAGEMENT INC
Active
Other names
Diagnostic Pavilion
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN IRA ETTINGER DPM (CFO/PRESIDENT)
(817) 877-3054
Entity
Organization
Contact information
Practice address
2001 COOPER STREET, FORT WORTH, TX 76104
(817) 877-3054
(817) 546-0851
Mailing address
2001 COOPER STREET, FORT WORTH, TX 76104
(817) 877-3054
(817) 546-0851
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
NULL
261QR0200X
Radiology Clinic/Center
R29901
TX
Other
Enumeration date
04/13/2007
Last updated
03/05/2012
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