Healthcare Provider Details

I. General information

NPI: 1962716027
Provider Name (Legal Business Name): CRYSTAL VIEW IMAGING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2010
Last Update Date: 07/31/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 BELLMEADE DR
GARLAND TX
75040-3505
US

IV. Provider business mailing address

306 BELLMEADE DR
GARLAND TX
75040-3505
US

V. Phone/Fax

Practice location:
  • Phone: 972-530-6831
  • Fax: 972-530-6842
Mailing address:
  • Phone: 972-530-6831
  • Fax: 972-530-6842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246X00000X
TaxonomyCardiovascular Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. CRYSTAL LANKFORD
Title or Position: CEO
Credential:
Phone: 972-804-9117