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General NPI Number Information
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NPI Number | 1568819803
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Entity Type | Organization
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Legal Business Name | VISION RADIOLOGY PROFESSIONAL LIMITED LIABILITY COMPANY
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Dates
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Enumeration Date | 05/17/2016
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Last Update Date | 08/09/2024
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Provider Practice Location Address
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Address Line | 2825 OAK LAWN AVE UNIT 192749
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City | DALLAS
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State | TX
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Zip | 75219-4688
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Country | US
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Telephone | 844-389-5711
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Fax | 877-880-2039
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Provider Business Mailing Address
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Address Line | 2825 OAK LAWN AVE UNIT 192749
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City | DALLAS
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State | TX
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Zip | 75219-4688
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Country | US
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Telephone | 844-389-5711
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Fax | 877-880-2039
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | RAYMOND MC HSU
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Credential | MD
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Telephone | 844-389-5711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 802416240
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License Number State | TX
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