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General NPI Number Information
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NPI Number | 1023391414
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Entity Type | Organization
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Legal Business Name | PRIME DIAGNOSTIC IMAGING OF DUNCANVILLE LLC
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Dates
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Enumeration Date | 09/22/2011
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Last Update Date | 09/22/2011
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Provider Practice Location Address
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Address Line | 1034 E HIGHWAY 67
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City | DUNCANVILLE
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State | TX
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Zip | 75137-2704
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Country | US
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Telephone | 214-341-8770
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Fax |
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Provider Business Mailing Address
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Address Line | 12840 HILLCREST PLAZA DRIVE SUITE E100
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City | DALLAS
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State | TX
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Zip | 75230
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | JAMIE L HELLMAN
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Credential |
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Telephone | 214-341-8770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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