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NPI Code Detail

MEDICARE: NORTHEAST TEXAS RADIOLOGY CONSULTANTS

MEDICARE: NORTHEAST TEXAS RADIOLOGY CONSULTANTS
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
12085R0202XDiagnostic Radiology Physician

Other Identifiers

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

General Provider Information

NPI Number : 1629029715
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHEAST TEXAS RADIOLOGY CONSULTANTS
Provider Business Mailing Address
First Line : 4777 US HIGHWAY 259
Second Line :
City : LONGVIEW
State : TX
Zip : 75605-7668
Country : US
Telephone Number : 903-663-4800
Fax Number : 903-663-0378
Provider Business Practice Location Address
First Line : 2001 N JEFFERSON AVE
Second Line :
City : MT PLEASANT
State : TX
Zip : 75455-2371
Country : US
Telephone Number : 903-577-6186
Fax Number : 903-577-6131
Authorized Official
Title or Position : PRESIDENT
Name : MILAS DAVIS JR.
Credential : M.D.
Telephone Number : 903-577-6186
Provider Enumeration Date : 05/13/2006
Last Update Date : 11/30/2007

Similar Medicare Providers

1174526529 — TITUS COUNTY HOSPITAL DISTRICT
Practice Location Address:
2001 N JEFFERSON AVE
MT PLEASANT, TX
75455-2371
Practice Phone: 903-577-6000
Practice Fax: 903-577-6027
1619960168 — DR. JON STEPHEN TOMPKINS D.O.
Practice Location Address:
2001 N JEFFERSON AVE , SUITE 204
MT PLEASANT, TX
75455-2371
Practice Phone: 903-577-7003
Practice Fax: 903-577-3933
1851343354 — CURTIS ALAN EVETTS M.D.
Practice Location Address:
2001 N JEFFERSON AVE
MT PLEASANT, TX
75455-2371
Practice Phone: 903-577-6000
Practice Fax:
1073542759 — CLINICAL PARTNERS - MT PLEASANT
Practice Location Address:
2001 N JEFFERSON AVE
MT PLEASANT, TX
75455-2371
Practice Phone: 903-663-3600
Practice Fax: 866-777-9502
1124040498 — REBECCA P THOMAS CRNA
Practice Location Address:
2001 N JEFFERSON AVE
MT PLEASANT, TX
75455-2371
Practice Phone: 903-577-6000
Practice Fax: 903-577-6027
1467476424 — MELISSA BAUMGARDNER CRNA
Practice Location Address:
2001 N JEFFERSON AVE
MT PLEASANT, TX
75455-2371
Practice Phone: 903-577-6000
Practice Fax:

Directions to “NORTHEAST TEXAS RADIOLOGY CONSULTANTS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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