Basic Information
| Provider Information | |||||||||
| NPI: | 1003846841 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | IRVING RADIOLOGICAL ASSOCIATES LLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1888 | ||||||||
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| City: | GREENVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8009452455 | ||||||||
| FaxNumber: | 9034532525 | ||||||||
| Practice Location | |||||||||
| Address1: | 2301 MARSH LANE | ||||||||
| Address2: | |||||||||
| City: | PLANO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750938497 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9724281600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/04/2006 | ||||||||
| LastUpdateDate: | 09/02/2008 | ||||||||
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| AuthorizedOfficialLastName: | MEICHES | ||||||||
| AuthorizedOfficialFirstName: | MARK | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | AUTHORIZED SIGNER | ||||||||
| AuthorizedOfficialTelephone: | 9725797575 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.