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General NPI Number Information
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NPI Number | 1265745632
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Entity Type | Organization
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Legal Business Name | BLUE STAR RADIOLOGY ASSOCIATES
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Dates
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Enumeration Date | 07/14/2010
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Last Update Date | 05/31/2011
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Provider Practice Location Address
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Address Line | 3000 CORPORATE CT SUITE 400
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City | FLOWER MOUND
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State | TX
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Zip | 75028-2299
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Country | US
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Telephone | 214-647-6165
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Fax | 214-647-6166
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Provider Business Mailing Address
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Address Line | 3000 CORPORATE CT SUITE 400
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City | FLOWER MOUND
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State | TX
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Zip | 75028-2299
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Country | US
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Telephone | 214-647-6165
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Fax | 214-647-6166
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL BRIAN JONES
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Credential | MD
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Telephone | 214-647-6165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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