Organization
CLEARSKY MRI & DIAGNOSTIC AT DENTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACKSON JACOB (GENERAL MANAGER)
(214) 328-3333
Entity
Organization
Contact information
Practice address
3118 LAS COLINAS DR, DENTON, TX 76207-3422
(940) 387-1500
(940) 566-1841
Mailing address
PO BOX 814230, DALLAS, TX 75381-4230
(214) 328-3333
(214) 328-3330
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
—
—
293D00000X
Physiological Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0383DC
BLUE CROSS
TX
Enumeration date
01/09/2007
Last updated
10/08/2008
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