Basic Information
Provider Information
NPI: 1063528461
EntityType: 2
ReplacementNPI:  
OrganizationName: RADIOLOGY ASSOCIATES OF DENISON, LLP
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1302 HWY 91 NORTH
Address2:  
City: DENISON
State: TX
PostalCode: 75020
CountryCode: US
TelephoneNumber: 9034651857
FaxNumber: 9033278023
Practice Location
Address1: 504 LIPSCOMB ST
Address2: RADIOLOGY DEPT
City: BONHAM
State: TX
PostalCode: 754184028
CountryCode: US
TelephoneNumber: 9035838585
FaxNumber: 9036407601
Other Information
ProviderEnumerationDate: 08/21/2006
LastUpdateDate: 12/20/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: HENSLEE
AuthorizedOfficialFirstName: DOROTHY
AuthorizedOfficialMiddleName: L
AuthorizedOfficialTitleorPosition: CEO/PRACTICE MGR
AuthorizedOfficialTelephone: 9034659508
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MRS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
174400000X TXY193400000X SINGLE SPECIALTY GROUPOther Service ProvidersSpecialist 

ID Information
IDTypeStateIssuerDescription
11262780105TX MEDICAID


Home