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General NPI Number Information
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NPI Number | 1447284575
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Entity Type | Organization
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Legal Business Name | GEMINI DIGITAL IMAGING
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2704 N GALLOWAY AVE SUITE 100
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City | MESQUITE
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State | TX
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Zip | 75150-6378
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Country | US
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Telephone | 972-682-6655
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Fax | 972-682-6679
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Provider Business Mailing Address
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Address Line | 2704 N GALLOWAY AVE SUITE 100
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City | MESQUITE
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State | TX
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Zip | 75150-6378
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Country | US
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Telephone | 972-682-6655
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Fax | 972-682-6679
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Authorized Official
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Title or Position | CFO
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Name | NIK MAHTANI
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Credential |
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Telephone | 972-682-6655
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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 | R22790
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License Number State | TX
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