Organization
CLEBURNE IMAGING, LLC
Active
Organization
CLEBURNE IMAGING, LLC
Active
Other names
Prestige Imaging, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MATT H PURSER (PRESIDENT)
(469) 916-8894
Entity
Organization
Contact information
Practice address
106 HYDE PARK BLVD, SUITE 200, CLEBURNE, TX 76033-4537
(817) 558-1940
(817) 558-1960
Mailing address
106 HYDE PARK, SUITE 200, CLEBURNE, TX 76033-4537
(817) 558-1940
(817) 558-1960
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
175352703
—
TX
01
—
P00305755
MEDICARE RAIL ROAD
TX
Enumeration date
06/23/2006
Last updated
11/16/2012
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