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General NPI Number Information
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NPI Number | 1851322473
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Entity Type | Organization
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Legal Business Name | PRESTIGE IMAGING, LLC
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 10/11/2007
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Provider Practice Location Address
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Address Line | 820 E CARTWRIGHT RD SUITE 100
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City | MESQUITE
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State | TX
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Zip | 75149-6000
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Country | US
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Telephone | 972-288-2077
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Fax | 972-329-0311
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Provider Business Mailing Address
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Address Line | 820 E CARTWRIGHT RD SUITE 100
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City | MESQUITE
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State | TX
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Zip | 75149-6000
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Country | US
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Telephone | 972-288-2077
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Fax | 972-329-0311
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Authorized Official
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Title or Position | FACILITY DIRECTOR
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Name | MS. KIM D CRUZ
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Credential |
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Telephone | 817-558-1940
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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 | R29470
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License Number State | TX
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