Organization
GEMINI DIGITAL IMAGING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIK MAHTANI (CFO)
(972) 682-6655
Entity
Organization
Contact information
Practice address
2704 N GALLOWAY AVE, SUITE 100, MESQUITE, TX 75150-6378
(972) 682-6655
(972) 682-6679
Mailing address
2704 N GALLOWAY AVE, SUITE 100, MESQUITE, TX 75150-6378
(972) 682-6655
(972) 682-6679
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
R22790
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0201DC
BLUE CROSS BLUE SHIELD
—
Enumeration date
07/11/2006
Last updated
08/22/2020
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