Organization
DESOTO DIAGNOSTIC IMAGING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC S BENNOS MD, V. PRESIDENT (V.P.)
(972) 274-3175
Entity
Organization
Contact information
Practice address
201 N BECKLEY AVE, FLOWER MOUND, TX 75115
(972) 274-3175
(972) 223-0586
Mailing address
201 N BECKLEY AVE, DESOTO, TX 75115
(972) 274-3175
(972) 223-0586
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MDG 7164
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MDG7164
GROUP
—
Enumeration date
07/08/2005
Last updated
08/22/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up