Organization
ETHEL SHADE DBA SURE SHOT X-RAY MOBILE X-RAY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ETHEL SHADE RT (OWNER)
(972) 822-9292
Entity
Organization
Contact information
Practice address
7310 S WESTMORELAND RD STE 11, DALLAS, TX 75237-3015
(972) 822-9292
(972) 298-1137
Mailing address
7310 S WESTMORELAND RD STE 11, DALLAS, TX 75237-3015
(972) 822-9292
(972) 298-1137
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
R31722
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R31722
RADIOLOGY
TX
Enumeration date
01/07/2008
Last updated
12/15/2008
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