Organization
MAXUM HEALTH SERVICES CORP
Active
Other names
InSight Diag Preston
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN G DRAZBA (SENIOR V.P. & CHIEF ACCOUNTING OFCR)
(949) 282-6000
Entity
Organization
Contact information
Practice address
17950 PRESTON RD, STE 120, DALLAS, TX 75252-5793
(972) 931-7979
(972) 931-5212
Mailing address
PO BOX 848074, DALLAS, TX 75284-8074
(949) 282-6000
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130085706
—
TX
01
—
470000905
RAILROAD MEDICARE
TX
Enumeration date
04/28/2006
Last updated
06/11/2008
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