Organization
STAT X-RAY OF TEXAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PARAMPOTTIL THARIAN ISSAC TECH (OWNER)
(972) 772-4864
Entity
Organization
Contact information
Practice address
4124 GUS THOMASSON ROAD, MESQUITE, TX 75150-2226
(972) 682-0484
(214) 221-5600
Mailing address
4124 GUS THOMASSON ROAD, MESQUITE, TX 75150-2226
(972) 682-0484
(214) 221-5600
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
—
—
2471S1302X
Sonography Radiologic Technologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
459840
BCBS
TX
Enumeration date
09/14/2006
Last updated
12/06/2007
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