Basic Information
| Provider Information | |||||||||
| NPI: | 1558423798 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PREFERRED IMAGING HEB, LP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 674093 | ||||||||
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| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752674093 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9724791129 | ||||||||
| FaxNumber: | 9724791118 | ||||||||
| Practice Location | |||||||||
| Address1: | 809 W HARWOOD RD | ||||||||
| Address2: | STE 100 | ||||||||
| City: | HURST | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760543289 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8177885502 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/14/2006 | ||||||||
| LastUpdateDate: | 09/30/2016 | ||||||||
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| AuthorizedOfficialLastName: | MCGILL | ||||||||
| AuthorizedOfficialFirstName: | KRISTY | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF NETWORK DEVELOPMENT | ||||||||
| AuthorizedOfficialTelephone: | 9722157410 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2471C3401X | N | 193200000X MULTI-SPECIALTY GROUP | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Computed Tomography | 2471M1202X | N | 193200000X MULTI-SPECIALTY GROUP | Technologists, Technicians & Other Technical Service Providers | Radiologic Technologist | Magnetic Resonance Imaging | 261QM1200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Magnetic Resonance Imaging (MRI) |
No ID Information.