Healthcare Provider Details

I. General information

NPI: 1033175302
Provider Name (Legal Business Name): ANGELINA DIAGNOSTIC RADIOLOGY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 W FRANK AVE
LUFKIN TX
75904-3357
US

IV. Provider business mailing address

PO BOX 3488
TUPELO MS
38803-3488
US

V. Phone/Fax

Practice location:
  • Phone: 936-634-8111
  • Fax:
Mailing address:
  • Phone: 479-452-9416
  • Fax: 479-242-1990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HAROLD R LEVINE II
Title or Position: PRESIDENT
Credential: MD
Phone: 479-452-9416