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General NPI Number Information
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NPI Number | 1083363865
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Entity Type | Organization
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Legal Business Name | ZOOM DIAGNOSTIC IMAGING DURANT LLC
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Dates
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Enumeration Date | 03/21/2022
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Last Update Date | 03/21/2022
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Provider Practice Location Address
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Address Line | 1228 MERRICK DR
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City | ARDMORE
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State | OK
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Zip | 73401-1824
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Country | US
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Telephone | 580-319-5091
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Fax |
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Provider Business Mailing Address
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Address Line | 3508 SOUTHWESTERN BLVD
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City | DALLAS
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State | TX
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Zip | 75225-7454
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Country | US
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Telephone | 214-504-6156
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAVID SAVAGE
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Credential |
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Telephone | 214-540-6156
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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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