MEDICARE: D2 IMAGING

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	261QR0208X	Mobile Radiology Clinic/Center

General Provider Information

NPI Number	:	1235135898
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	D2 IMAGING

Provider Business Mailing Address
First Line	:	6320 SOUTHWEST BLVD
Second Line	:	STE 104
City	:	FORT WORTH
State	:	TX
Zip	:	76109-3961
Country	:	US
Telephone Number	:	817-921-6015
Fax Number	:	817-763-9492

Provider Business Practice Location Address
First Line	:	6320 SOUTHWEST BLVD
Second Line	:	STE 104
City	:	FORT WORTH
State	:	TX
Zip	:	76109-3961
Country	:	US
Telephone Number	:	817-921-6015
Fax Number	:	817-763-9492

Authorized Official
Title or Position	:	GENERAL PARTNER
Name	:	DARREN C LADNER
Credential	:	RDMS, RVT
Telephone Number	:	817-921-6015

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	08/22/2020

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Directions to “D2 IMAGING ” Practice Location

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