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Organization

HORIZON MRI OF LEWISVILLE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MARTIN J KERN (SENIOR VICE PRESIDENT)
(941) 925-3490
Entity
Organization

Contact information

Practice address
500 N VALLEY PKWY, STE 108, LEWISVILLE, TX 75067-3479
(972) 420-6745
(972) 420-6741
Mailing address
240 N WASHINGTON BLVD, SARASOTA, FL 34236-5945
(941) 925-3490
(941) 953-4452

Taxonomy

Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0308DC
BCBS PROV #
TX
01
242880
AMERIGROUP
01
7907597
AETNA/MEDSOLTIONS-HMO/PPO
Enumeration date
06/13/2005
Last updated
08/22/2020
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