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General NPI Number Information
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NPI Number | 1336033752
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Entity Type | Organization
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Legal Business Name | TEXAS DIAGNOSTIC RADIOLOGY PA
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 1606 HEADWAY CIR STE 19038
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City | AUSTIN
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State | TX
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Zip | 78754-5123
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Country | US
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Telephone | 214-831-6640
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Fax |
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Provider Business Mailing Address
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Address Line | 1606 HEADWAY CIR STE 19038
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City | AUSTIN
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State | TX
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Zip | 78754-5123
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | JEFFREY WARONKER
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Credential |
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Telephone | 214-831-6640
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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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