Organization
GRAPEVINE RADIOLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT FOREST WOOMER MD (PRESIDENT)
(817) 488-7546
Entity
Organization
Contact information
Practice address
1650 W COLLEGE STREET, GRAPEVINE, TX 76051
(817) 488-7546
Mailing address
PO BOX 740968, DALLAS, TX 75374-0968
(800) 563-2964
(903) 453-2541
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
093777301
—
TX
Enumeration date
04/26/2006
Last updated
05/14/2008
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