Organization
ELITE DIAGNOSTIC IMAGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN IPPOLITO (MANAGER)
(214) 228-0701
Entity
Organization
Contact information
Practice address
5616 WARREN PKWY STE 102, FRISCO, TX 75034-4166
(214) 762-9084
Mailing address
5616 WARREN PKWY STE 102, FRISCO, TX 75034-4166
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
—
—
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
07/19/2023
Last updated
07/19/2023
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