Organization
RADIOLOGY & DIAGNOSTIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL BENNETT M.D. (PRESIDENT)
(903) 541-5171
Entity
Organization
Contact information
Practice address
501 S RAGSDALE ST, JACKSONVILLE, TX 75766-2434
(903) 541-5171
Mailing address
4777 US HIGHWAY 259, LONGVIEW, TX 75605-7668
(903) 663-4800
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
05/09/2006
Last updated
12/12/2007
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