Basic Information
| Provider Information | |||||||||
| NPI: | 1942489125 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ADVANCED MEDICAL IMAGING OF NORTH TEXAS LP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1720 | ||||||||
| Address2: | |||||||||
| City: | SHERMAN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750911720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9034659508 | ||||||||
| FaxNumber: | 9033278023 | ||||||||
| Practice Location | |||||||||
| Address1: | 2622 NORTH US HIGHWAY 75 | ||||||||
| Address2: | |||||||||
| City: | SHERMAN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 75090 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9038688730 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2007 | ||||||||
| LastUpdateDate: | 08/04/2008 | ||||||||
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| AuthorizedOfficialLastName: | HENSLEE | ||||||||
| AuthorizedOfficialFirstName: | DOROTHY | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 9034659508 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.