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General NPI Number Information
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NPI Number | 1407014590
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Entity Type | Organization
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Legal Business Name | AMERICAN TELERADIOLOGY INC
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Dates
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Enumeration Date | 05/27/2008
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Last Update Date | 01/13/2010
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Provider Practice Location Address
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Address Line | 3208 COLE AVE SUITE 1208
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City | DALLAS
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State | TX
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Zip | 75204-1349
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Country | US
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Telephone | 214-244-3156
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Fax | 214-880-0977
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Provider Business Mailing Address
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Address Line | PO BOX 701506
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City | DALLAS
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State | TX
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Zip | 75370-1506
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Country | US
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Telephone | 972-210-7002
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Fax | 972-939-1293
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Authorized Official
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Title or Position | CEO
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Name | DR. THOMAS VARGHESE
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Credential | M.D
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Telephone | 214-244-3156
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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 | L8990
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License Number State | TX
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