Basic Information
| Provider Information | |||||||||
| NPI: | 1295792018 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEART OF TEXAS RADIOLOGY PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1888 | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8664229889 | ||||||||
| FaxNumber: | 9034532525 | ||||||||
| Practice Location | |||||||||
| Address1: | 1501 BURNET DRIVE | ||||||||
| Address2: | |||||||||
| City: | BROWNWOOD | ||||||||
| State: | TX | ||||||||
| PostalCode: | 76801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9156468541 | ||||||||
| FaxNumber: | 9156465459 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | WRIGHT | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 36256465880 | ||||||||
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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.