Organization
MAXUM HEALTH SERVICES CORP
Active
Other names
InSight Diagnostic Center - Eighth Ave
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES F. STANLEY (CHIEF FINANCIAL OFFICER; TREASURER)
(949) 282-6000
Entity
Organization
Contact information
Practice address
1199 8TH AVE, FORT WORTH, TX 76104-4102
(817) 335-9729
(817) 877-3868
Mailing address
PO BOX 848074, DALLAS, TX 75284-8074
(949) 282-6000
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155916301
—
TX
01
—
470001131
RAILROAD MEDICARE
TX
Enumeration date
04/28/2006
Last updated
08/20/2012
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