Organization
INNATE IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY D MARTIN JR. DC (PRESIDENT)
(469) 215-3494
Entity
Organization
Contact information
Practice address
7504 SAN JACINTO PL, PLANO, TX 75024-3233
(469) 310-4977
(469) 214-9981
Mailing address
7504 SAN JACINTO PL, PLANO, TX 75024-3233
(469) 310-4977
(469) 214-9981
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
—
—
Other
Enumeration date
09/30/2019
Last updated
11/17/2020
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