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General NPI Number Information
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NPI Number | 1114074614
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Entity Type | Organization
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Legal Business Name | STONEBRIAR IMAGING LP
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 05/17/2012
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Provider Practice Location Address
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Address Line | 3550 PARKWOOD BLVD SUITE C 302
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City | FRISCO
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State | TX
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Zip | 75034-1903
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Country | US
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Telephone | 214-618-4674
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Fax | 214-618-4681
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Provider Business Mailing Address
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Address Line | 3550 PARKWOOD BLVD C302
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City | FRISCO
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State | TX
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Zip | 75034-1903
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Country | US
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Telephone | 214-618-4674
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Fax | 214-618-4681
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MR. PHILLIP A CLIFFORD JR.
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Credential |
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Telephone | 214-618-4674
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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 | R28955
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License Number State | TX
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