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Organization

TIDC-GRAPEVINE, INC

Active
Other names
Texas Imaging & Diagnostic Center
Organization subpart
No

Provider details

NPI number
Authorized official
EMIL GEORGIO CERULLO (CEO)
(214) 357-5229
Entity
Organization

Contact information

Practice address
5311 WILLIAM D TATE AVE, GRAPEVINE, TX 76051-7365
(817) 267-9500
(817) 545-9400
Mailing address
5311 WILLIAM D TATE AVE, GRAPEVINE, TX 76051-7365
(817) 267-9500
(817) 545-9400

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
R22410
TX

Other

Enumeration date
04/18/2006
Last updated
09/19/2007
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