MEDICARE: PARKER COUNTY IMAGING CENTER LLC

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	:	1376492736
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARKER COUNTY IMAGING CENTER LLC

Provider Business Mailing Address
First Line	:	PO BOX 717
Second Line	:
City	:	WEATHERFORD
State	:	TX
Zip	:	76086-0717
Country	:	US
Telephone Number	:	817-658-4357
Fax Number	:

Provider Business Practice Location Address
First Line	:	1701 MARTIN DR
Second Line	:
City	:	WEATHERFORD
State	:	TX
Zip	:	76086
Country	:	US
Telephone Number	:	817-658-4357
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	NICK GASCA
Credential	:
Telephone Number	:	817-658-4357

Provider Enumeration Date	:	01/27/2026
Last Update Date	:	03/25/2026

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Directions to “PARKER COUNTY IMAGING CENTER LLC ” Practice Location

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