Healthcare Provider Details

I. General information

NPI: 1396793840
Provider Name (Legal Business Name): DIAGNOSTIC HEALTH CENTERS OF TEXAS LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 07/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5455 BASSWOOD BLVD SUITE 550
FT WORTH TX
76137-4476
US

IV. Provider business mailing address

2764 PELHAM PKWY
PELHAM AL
35124-1702
US

V. Phone/Fax

Practice location:
  • Phone: 817-428-5002
  • Fax: 817-428-8101
Mailing address:
  • Phone: 205-685-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: SHERI MILLER
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 205-685-5000