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NPI Code Detail

MEDICARE: METROPOLITAN RADIOLOGY, INC.

MEDICARE: METROPOLITAN RADIOLOGY, INC.
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
1261QR0200XRadiology Clinic/Center

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1DN8753OTHERTXMEDICARE RAILROAD

Other Identifiers

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

General Provider Information

NPI Number : 1881714467
Entity Type Code : Organization
Provider Name (Legal Business Name) : METROPOLITAN RADIOLOGY, INC.
Provider Business Mailing Address
First Line : 10500 STEPPINGTON DR
Second Line : SUITE 100A
City : DALLAS
State : TX
Zip : 75230-4561
Country : US
Telephone Number : 214-987-4601
Fax Number : 214-987-4039
Provider Business Practice Location Address
First Line : 10500 STEPPINGTON DR
Second Line : SUITE 100A
City : DALLAS
State : TX
Zip : 75230-4561
Country : US
Telephone Number : 214-987-4601
Fax Number : 214-987-4039
Authorized Official
Title or Position : PRESIDENT
Name : DR. JACK DENNIS CONNALLY
Credential : M.D.
Telephone Number : 214-987-4601
Provider Enumeration Date : 03/29/2007
Last Update Date : 03/13/2009

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Directions to “METROPOLITAN RADIOLOGY, INC. ” Practice Location

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