MEDICARE: IMAGING CONSULTANTS OF DENTON

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	2085R0202X	Diagnostic Radiology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295787968
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IMAGING CONSULTANTS OF DENTON

Provider Business Mailing Address
First Line	:	PO BOX 1888
Second Line	:
City	:	GREENVILLE
State	:	TX
Zip	:	75403
Country	:	US
Telephone Number	:	800-945-2455
Fax Number	:	903-453-2541

Provider Business Practice Location Address
First Line	:	3305 CORINTH PARKWAY
Second Line	:
City	:	CORINTH
State	:	TX
Zip	:	76208
Country	:	US
Telephone Number	:	940-270-4150
Fax Number	:	940-270-4151

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. GLORIA P HOWELL
Credential	:
Telephone Number	:	940-387-6159

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	03/09/2009

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Directions to “IMAGING CONSULTANTS OF DENTON ” Practice Location

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