Healthcare Provider Details

I. General information

NPI: 1417052002
Provider Name (Legal Business Name): STAT X-RAY OF TEXAS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4124 GUS THOMASSON ROAD
MESQUITE TX
75150-2226
US

IV. Provider business mailing address

4124 GUS THOMASSON ROAD
MESQUITE TX
75150-2226
US

V. Phone/Fax

Practice location:
  • Phone: 972-682-0484
  • Fax: 214-221-5600
Mailing address:
  • Phone: 972-682-0484
  • Fax: 214-221-5600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: PARAMPOTTIL THARIAN ISSAC
Title or Position: OWNER
Credential: TECH
Phone: 972-772-4864