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General NPI Number Information
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NPI Number | 1093752891
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Entity Type | Organization
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Legal Business Name | IMPEL MANAGEMENT SERVICES, LLC
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 900 AIRPORT FWY SUITE 158
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City | HURST
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State | TX
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Zip | 76054-3250
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Country | US
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Telephone | 817-514-4006
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Fax | 817-514-7821
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Provider Business Mailing Address
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Address Line | 900 AIRPORT FWY SUITE 158
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City | HURST
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State | TX
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Zip | 76054-3250
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Country | US
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Telephone | 817-514-4006
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Fax | 817-514-7821
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Authorized Official
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Title or Position | DIAGNOSTIC OPERATIONS MANAGER
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Name | CORY S LANGELY
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Credential |
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Telephone | 817-514-4009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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