Healthcare Provider Details

I. General information

NPI: 1063528461
Provider Name (Legal Business Name): RADIOLOGY ASSOCIATES OF DENISON, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 12/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 LIPSCOMB ST RADIOLOGY DEPT
BONHAM TX
75418-4028
US

IV. Provider business mailing address

1302 HWY 91 NORTH
DENISON TX
75020
US

V. Phone/Fax

Practice location:
  • Phone: 903-583-8585
  • Fax: 903-640-7601
Mailing address:
  • Phone: 903-465-1857
  • Fax: 903-327-8023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateTX

VIII. Authorized Official

Name: MRS. DOROTHY L HENSLEE
Title or Position: CEO/PRACTICE MGR
Credential:
Phone: 903-465-9508