Organization
HEALTHTEXAS PROVIDER NETWORK - IMAGING, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELLEN FOURTON (DIRECTOR)
(972) 860-8649
Entity
Organization
Contact information
Practice address
9101 N CENTRAL EXPY, SUITE 100, DALLAS, TX 75231-5927
(214) 820-1606
(214) 820-1610
Mailing address
8080 N CENTRAL EXPY, SUITE 1650, DALLAS, TX 75206-1838
(972) 860-8648
(972) 860-8679
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
189095601
—
TX
Enumeration date
07/04/2006
Last updated
08/17/2009
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