Organization
METHODIST-CDI
Active
Other names
RAYUS Radiology
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN C HOLMAN (SPECIAL ASSISTANT SECRETARY)
(952) 513-6831
Entity
Organization
Contact information
Practice address
2975 E BROAD ST STE 101, MANSFIELD, TX 76063-9185
(214) 420-5445
(817) 453-8082
Mailing address
5775 WAYZATA BLVD, SUITE 400, ST LOUIS PARK, MN 55416-1222
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
11/04/2016
Last updated
01/11/2022
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