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General NPI Number Information
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NPI Number | 1891491569
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Entity Type | Organization
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Legal Business Name | DIAGNOSTIC CENTER OF TEXAS
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Dates
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Enumeration Date | 02/03/2023
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Last Update Date | 02/03/2023
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Provider Practice Location Address
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Address Line | 891 KELLER PKWY
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City | KELLER
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State | TX
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Zip | 76248-2482
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Country | US
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Telephone | 817-888-8165
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Fax | 817-888-8165
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Provider Business Mailing Address
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Address Line | 11821 BASILWOOD DR
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City | FORT WORTH
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State | TX
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Zip | 76244-8871
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Country | US
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Telephone | 682-888-6592
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. KRISTAL ARNEZ FISHER
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Credential |
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Telephone | 817-888-8165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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