Organization
USMD DIAGNOSTIC SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL W BUKOSKY (PRESIDENT PPM)
(817) 514-5290
Entity
Organization
Contact information
Practice address
900 AIRPORT FREEWAY, SUITE 132, HURST, TX 76054-3252
(817) 514-5200
(817) 514-5210
Mailing address
PO BOX 678168, DALLAS, TX 75267-8168
(972) 847-0712
(817) 514-5246
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
07/30/2010
Last updated
11/08/2016
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