# GED MEDICAL MANAGEMENT INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Diagnostic Pavilion
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942424452
- **Authorized official:** ALAN IRA ETTINGER DPM (CFO/PRESIDENT)
- **Authorized official phone:** (817) 877-3054

## Contact information

- **Practice address:** 2001 COOPER STREET, FORT WORTH, TX 76104
- **Practice address phone:** (817) 877-3054
- **Practice address fax:** (817) 546-0851
- **Mailing address:** 2001 COOPER STREET, FORT WORTH, TX 76104
- **Mailing address phone:** (817) 877-3054
- **Mailing address fax:** (817) 546-0851

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1200X | Magnetic Resonance Imaging (MRI) Clinic/Center | — | NULL | Yes |
| 261QR0200X | Radiology Clinic/Center | R29901 | TX | — |

## Other

- **Enumeration date:** 04/13/2007
- **Last updated:** 03/05/2012