Organization
LOUISIANA TELERAD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY ROSE MD (PRESIDENT)
(469) 401-2386
Entity
Organization
Contact information
Practice address
75368 MOONSHADOW LN, ABITA SPRINGS, LA 70420-4026
(469) 401-2386
Mailing address
13737 NOEL RD, SUITE 1600, DALLAS, TX 75240-1331
(469) 401-2386
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
04/26/2010
Last updated
11/11/2015
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