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Organization

BDNT RADIOLOGY, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RAVI VENUGOPAL (DIRECTOR)
(817) 749-2001
Entity
Organization

Contact information

Practice address
2817 S MAYHILL RD STE 270, DENTON, TX 76208-5970
(817) 749-2001
(940) 483-1568
Mailing address
PO BOX 92038, SOUTHLAKE, TX 76092
(817) 749-2001
(940) 483-1568

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00627Z
MEDICARE GROUP NUMBER
TX
Enumeration date
03/12/2008
Last updated
02/06/2017
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