MEDICARE: TOUCHSTONE IMAGING OF MESQUITE, LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0200X	Radiology Clinic/Center

General Provider Information

NPI Number	:	1174833222
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOUCHSTONE IMAGING OF MESQUITE, LP

Provider Business Mailing Address
First Line	:	PO BOX 116662
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30368-6662
Country	:	US
Telephone Number	:	720-974-0334
Fax Number	:	720-385-2303

Provider Business Practice Location Address
First Line	:	6001 HARRIS PKWY
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-4103
Country	:	US
Telephone Number	:	817-294-1131
Fax Number	:	817-294-3882

Authorized Official
Title or Position	:	CHIEF MANAGER
Name	:	MR. CHRISTIAN C. RICE JR.
Credential	:
Telephone Number	:	615-661-9200

Provider Enumeration Date	:	10/07/2010
Last Update Date	:	10/07/2010

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