Healthcare Provider Details
I. General information
NPI: 1851786511
Provider Name (Legal Business Name): OCULUS IMAGING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/31/2015
Last Update Date: 03/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8350 DALLAS PARKWAY SUITE 200
FRISCO TX
75034
US
IV. Provider business mailing address
PO BOX 1402
COLLEYVILLE TX
76034-1402
US
V. Phone/Fax
- Phone: 817-821-3568
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0200X |
| Taxonomy | Radiology Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
JANE
SCOTT
Title or Position: MANAGER
Credential:
Phone: 817-821-3568