Organization
ELITE VIEW IMAGING, LLC
Active
Parent organization
ELITE VIEW IMAGING, LLC
Other names
Broad Park Imaging, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ELITE VIEW IMAGING, LLC
Authorized official
JAMES A WALLER (MANAGER)
(817) 528-7044
Entity
Organization
Contact information
Practice address
1750 BROAD PARK CIR S, SUITE 300, MANSFIELD, TX 76063-7832
(682) 200-2517
(682) 200-2518
Mailing address
3120 W SOUTHLAKE BLVD, SUITE 140, SOUTHLAKE, TX 76092-6783
(817) 741-0808
(817) 741-0841
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
R33761-000
TX
Other
Enumeration date
04/12/2013
Last updated
04/12/2013
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