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General NPI Number Information
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NPI Number | 1245413319
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Entity Type | Organization
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Legal Business Name | DENNIS WHITSELL
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Dates
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Enumeration Date | 12/12/2007
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Last Update Date | 01/16/2008
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Provider Practice Location Address
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Address Line | 391 COUNTY ROAD 473
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City | DE LEON
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State | TX
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Zip | 76444-6221
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Country | US
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Telephone | 254-893-5181
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Fax | 877-879-7379
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Provider Business Mailing Address
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Address Line | 391 COUNTY ROAD 473
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City | DE LEON
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State | TX
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Zip | 76444-6221
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Country | US
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Telephone | 254-893-5181
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Fax | 877-879-7379
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Authorized Official
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Title or Position | OWNER /OPERATOR
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Name | MR. DENNIS DEE WHITSELL
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Credential | RT
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Telephone | 254-893-5181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471C3402X
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Taxonomy Name | Radiography Radiologic Technologist
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License Number | 12981
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License Number State | TX
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