=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750710091
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PREFERRED IMAGING AT THE MEDICAL CENTER, LTD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/07/2013
-----------------------------------------------------
Last Update Date | 11/07/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 318 W BELT LINE RD SUITE 301
-----------------------------------------------------
City | CEDAR HILL
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75104-1104
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-291-6888
-----------------------------------------------------
Fax | 972-291-6883
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 674056
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75267-4056
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-479-1115
-----------------------------------------------------
Fax | 972-346-8015
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | AMY ADAMS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 469-362-6909
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM1200X
-----------------------------------------------------
Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------