MEDICARE: ARLINGTON MEDICAL IMAGING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	293D00000X	Physiological Laboratory
2	2085R0202X	Diagnostic Radiology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063415008
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARLINGTON MEDICAL IMAGING LLC

Provider Business Mailing Address
First Line	:	2140 E SOUTHLAKE BLVD
Second Line	:	L-426
City	:	SOUTHLAKE
State	:	TX
Zip	:	76092-6516
Country	:	US
Telephone Number	:	214-502-8157
Fax Number	:

Provider Business Practice Location Address
First Line	:	3025 MATLOCK RD
Second Line	:	STE 100
City	:	ARLINGTON
State	:	TX
Zip	:	76015-2902
Country	:	US
Telephone Number	:	817-467-6099
Fax Number	:	972-739-1468

Authorized Official
Title or Position	:	OWNER
Name	:	DR. RAJESH GOGIA
Credential	:
Telephone Number	:	214-502-8157

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	07/27/2020

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Directions to “ARLINGTON MEDICAL IMAGING LLC ” Practice Location

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