Healthcare Provider Details

I. General information

NPI: 1699760074
Provider Name (Legal Business Name): OAK HILL RADIOLOGY ASSOC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 COTTAGE RD
CARTHAGE TX
75633-1466
US

IV. Provider business mailing address

269 COUNTY ROAD 193
GARY TX
75643-3793
US

V. Phone/Fax

Practice location:
  • Phone: 903-694-4942
  • Fax: 903-685-0192
Mailing address:
  • Phone: 903-685-0193
  • Fax: 903-685-0192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number32770
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number053088
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberR4009
License Number StateAR
# 4
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberD7619
License Number StateTX

VIII. Authorized Official

Name: DONALD RALPH LASH
Title or Position: OWNER
Credential: DO
Phone: 903-685-0193