Healthcare Provider Details

I. General information

NPI: 1881028397
Provider Name (Legal Business Name): PREFERRED IMAGING OF FRISCO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2013
Last Update Date: 04/07/2022
Certification Date: 04/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4525 OHIO DR SUITE 200
FRISCO TX
75035-5710
US

IV. Provider business mailing address

8300 W SUNRISE BLVD
PLANTATION FL
33322-5406
US

V. Phone/Fax

Practice location:
  • Phone: 469-300-2025
  • Fax:
Mailing address:
  • Phone: 754-206-6198
  • Fax: 754-206-6198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LAURA KASSA
Title or Position: SR VICE PRESIDENT
Credential:
Phone: 904-515-0362