Organization
MEDIVEST DENTON, LP
Active
Other names
Monticello Diagnostic Imaging of Decatur
Organization subpart
No
Provider details
NPI number
Authorized official
CHELSEA MECHELLE HOLDER (PRACTICE ADMINISTRATOR)
(817) 377-3800
Entity
Organization
Contact information
Practice address
1713 S FM 51 # 104, DECATUR, TX 76234-3642
(817) 377-3800
(817) 377-3801
Mailing address
3712 W 7TH ST, FORT WORTH, TX 76107-2536
(817) 202-5179
(817) 377-3801
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
—
—
261QR0200X
Radiology Clinic/Center
Primary
—
—
293D00000X
Physiological Laboratory
—
—
Other
Enumeration date
01/13/2022
Last updated
12/27/2024
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