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General NPI Number Information
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NPI Number | 1023717923
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Entity Type | Organization
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Legal Business Name | AMBULANT IMAGING LLC
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Dates
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Enumeration Date | 02/28/2023
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Last Update Date | 02/28/2023
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Provider Practice Location Address
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Address Line | 1338 JUNIPER LN
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City | LEWISVILLE
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State | TX
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Zip | 75077-2838
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Country | US
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Telephone | 214-989-5583
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Fax |
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Provider Business Mailing Address
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Address Line | 1338 JUNIPER LN
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City | LEWISVILLE
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State | TX
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Zip | 75077-2838
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Country | US
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Telephone | 121-498-9558
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DONALD BOULDIN
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Credential | RT(R)
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Telephone | 214-989-5583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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