Healthcare Provider Details

I. General information

NPI: 1558423798
Provider Name (Legal Business Name): PREFERRED IMAGING HEB, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 09/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 W HARWOOD RD STE 100
HURST TX
76054-3289
US

IV. Provider business mailing address

PO BOX 674093
DALLAS TX
75267-4093
US

V. Phone/Fax

Practice location:
  • Phone: 817-788-5502
  • Fax:
Mailing address:
  • Phone: 972-479-1129
  • Fax: 972-479-1118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2471C3401X
TaxonomyComputed Tomography Radiologic Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2471M1202X
TaxonomyMagnetic Resonance Imaging Radiologic Technologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KRISTY MCGILL
Title or Position: DIRECTOR OF NETWORK DEVELOPMENT
Credential:
Phone: 972-215-7410