Healthcare Provider Details
I. General information
NPI: 1447917539
Provider Name (Legal Business Name): ZOOM DIAGNOSTIC IMAGING HOLDINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/23/2021
Last Update Date: 11/23/2021
Certification Date: 11/23/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1113 W CHERRY AVE
ENID OK
73703-3320
US
IV. Provider business mailing address
3508 SOUTHWESTERN BLVD
DALLAS TX
75225-7454
US
V. Phone/Fax
- Phone: 580-540-3244
- Fax:
- Phone: 214-504-6156
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335V00000X |
| Taxonomy | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAVID
SAVAGE
Title or Position: OWNER
Credential:
Phone: 214-504-6156