Healthcare Provider Details
I. General information
NPI: 1861575615
Provider Name (Legal Business Name): PREFERRED IMAGING OF PLANO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/23/2006
Last Update Date: 10/21/2022
Certification Date: 10/21/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2205 N CENTRAL EXPWY. STE. 185
PLANO TX
75075-2591
US
IV. Provider business mailing address
8300 W SUNRISE BLVD
PLANTATION FL
33322-5406
US
V. Phone/Fax
- Phone: 972-312-0799
- Fax: 972-346-6566
- Phone: 800-730-0050
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0200X |
| Taxonomy | Radiology Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TONI
COOPER
Title or Position: DIRECTOR OF CREDENTIALING
Credential:
Phone: 754-206-6198