Organization
IMAGIN ETC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK GRAY JR. (BUSINESS MANAGER)
(972) 988-9800
Entity
Organization
Contact information
Practice address
655 S GREAT SOUTHWEST PKWY, GRAND PRAIRIE, TX 75051-1068
(214) 688-8717
(972) 988-9807
Mailing address
2507 MEDICAL ROW, SUITE 102, GRAND PRAIRIE, TX 75051-1070
(214) 688-8717
(972) 988-9807
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
TX
Other
Enumeration date
06/13/2011
Last updated
06/13/2011
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