Organization
MEDFUND LLC
Active
Other names
Horizon Open MRI of Las Colinas LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN J KERN (SENIOR VICE PRESIDENT)
(941) 925-3490
Entity
Organization
Contact information
Practice address
6550 N MACARTHUR BLVD, STE 120, IRVING, TX 75039-2823
(972) 444-0100
(972) 444-0282
Mailing address
240 N WASHINGTON BLVD, SARASOTA, FL 34236-5945
(941) 925-3490
(941) 953-4452
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0410DC
BCBS PROV
TX
01
—
268489
AMERIGROUP
—
01
—
7416610
AETNA/MEDSOLUTIONS
—
Enumeration date
05/24/2005
Last updated
08/22/2020
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