Organization
IDEAL MRI, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARL MILLER MD (PRESIDENT)
(734) 657-3868
Entity
Organization
Contact information
Practice address
2816 MARKETPLACE DR STE 120, WACO, TX 76711-2487
(833) 433-2567
(903) 663-9960
Mailing address
3206 4TH ST, LONGVIEW, TX 75605-5143
(903) 663-4800
(903) 663-9960
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
390647101
—
TX
Enumeration date
06/08/2018
Last updated
12/27/2023
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