Healthcare Provider Details
I. General information
NPI: 1255386751
Provider Name (Legal Business Name): RADIOLOGY OF NORTH TEXAS PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/23/2006
Last Update Date: 05/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2000 S FM 51
DECATUR TX
76234-3702
US
IV. Provider business mailing address
800 ROCKMEAD DR S:210
KINGWOOD TX
77339-2112
US
V. Phone/Fax
- Phone: 281-359-7788
- Fax: 281-359-7888
- Phone: 281-359-7788
- Fax: 281-359-7888
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JEFFREY
S
KRANTZ
Title or Position: PRESIDENT
Credential: D.O.
Phone: 281-359-7788