Basic Information
| Provider Information | |||||||||
| NPI: | 1164825444 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CT HEALTHCARE GROUP, LLC | ||||||||
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| OtherOrganizationName: | EXPERT WOMEN'S IMAGING | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7415 LAS COLINAS BLVD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | IRVING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750637568 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2143792700 | ||||||||
| FaxNumber: | 9728693875 | ||||||||
| Practice Location | |||||||||
| Address1: | 431 EAST STATE HWY.114 | ||||||||
| Address2: | SUITE 490 | ||||||||
| City: | SOUTHLAKE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 76092 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2143792700 | ||||||||
| FaxNumber: | 9728693875 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/01/2014 | ||||||||
| LastUpdateDate: | 10/01/2014 | ||||||||
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| AuthorizedOfficialLastName: | ECHT | ||||||||
| AuthorizedOfficialFirstName: | GREGORY | ||||||||
| AuthorizedOfficialMiddleName: | ALLEN | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2143792700 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | H6809 | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.