Basic Information
| Provider Information | |||||||||
| NPI: | 1336369636 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PREFERRED IMAGING OF GREENVILLE, LP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 269083 | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731269083 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9724791115 | ||||||||
| FaxNumber: | 9724791118 | ||||||||
| Practice Location | |||||||||
| Address1: | 4501 JOE RAMSEY BLVD | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4693626909 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/27/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | HOBBS | ||||||||
| AuthorizedOfficialFirstName: | GRADY | ||||||||
| AuthorizedOfficialMiddleName: | LAWSON | ||||||||
| AuthorizedOfficialTitleorPosition: | VP OPERATIONS | ||||||||
| AuthorizedOfficialTelephone: | 4696826743 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2471C3401X | X | 193200000X MULTI-SPECIALTY GROUP | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Computed Tomography | 2471C3402X | X | 193200000X MULTI-SPECIALTY GROUP | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Radiography | 2471M1202X | X | 193200000X MULTI-SPECIALTY GROUP | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Magnetic Resonance Imaging | 2471S1302X | X | 193200000X MULTI-SPECIALTY GROUP | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Sonography |
No ID Information.