Organization
MISSOURI TELERAD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP HECKENDORN (EXECUTIVE VICE PRESIDENT)
(214) 712-2074
Entity
Organization
Contact information
Practice address
816 HUNTINGTON RD, KANSAS CITY, MO 64113-1344
(816) 361-1562
(241) 712-2487
Mailing address
13737 NOEL RD, SUITE 1600, DALLAS, TX 75240-1331
(214) 712-2074
(214) 712-2487
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
04/26/2010
Last updated
07/24/2012
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