Organization
PREFERRED IMAGING OF GRAPEVINE/COLLEYVILLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA KASSA (SR VICE PRESIDENT)
(904) 515-0362
Entity
Organization
Contact information
Practice address
1600 W NORTHWEST HWY, STE. 1000, GRAPEVINE, TX 76051-8112
(817) 421-6285
(817) 886-2537
Mailing address
PO BOX 268945, OKLAHOMA CITY, OK 73126-8945
(972) 479-1115
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
283281802
—
TX
Enumeration date
10/23/2006
Last updated
10/21/2022
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