Organization
RADIOLOGY ASSOCIATES OF WICHITA FALLS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID DOUGLAS MOFFATT III MD (AUTHORIZED OFFICIAL/OWNER)
(940) 766-0217
Entity
Organization
Contact information
Practice address
808 BROOK AVE., WICHITA FALLS, TX 76301-4289
(940) 766-0217
(940) 766-0730
Mailing address
808 BROOK AVE., WICHITA FALLS, TX 76301-4289
(940) 766-0217
(940) 766-0730
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00BA07
BLUE CROSS/BS OF TX GRP.
TX
01
—
121739001
C S H C N
TX
01
—
121739002
SUPERIOR HEALTH PLAN
TX
05
—
121739002
—
TX
01
—
CP8288
RAILROAD MEDICARE/PALMET
TX
Enumeration date
10/02/2006
Last updated
11/01/2023
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