Healthcare Provider Details

I. General information

NPI: 1235214164
Provider Name (Legal Business Name): PREFERRED IMAGING OF GARLAND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 10/21/2022
Certification Date: 10/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1778 N PLANO RD STE 300
RICHARDSON TX
75081-1958
US

IV. Provider business mailing address

PO BOX 674025
DALLAS TX
75267-4025
US

V. Phone/Fax

Practice location:
  • Phone: 972-234-0004
  • Fax: 972-234-0035
Mailing address:
  • Phone: 972-479-1115
  • Fax: 972-479-1118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TONI COOPER
Title or Position: DIRECTOR OF CREDENTIALING
Credential:
Phone: 754-206-6198