Organization
FT WORTH DIAGNOSTIC RADIOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP MALONE (OPERATIONS MANAGER)
(405) 321-8125
Entity
Organization
Contact information
Practice address
1400 8TH AVE, FORT WORTH, TX 76104-4110
(469) 757-1000
Mailing address
PO BOX 103, ROCKWALL, TX 75087-0103
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
03/29/2006
Last updated
08/22/2020
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