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	261QM1200X	Magnetic Resonance Imaging (MRI) Clinic/Center
2	261QR0200X	Radiology Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0346DC	OTHER	TX	BLUECROSSBLUESHIEL OF TX
2	75231	OTHER	TX	CHAMPUS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	P00188436	OTHER	TX	PALMETTO GBA

General Provider Information

NPI Number	:	1740274166
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	:	972-216-4411
Fax Number	:	972-216-7346

Provider Business Practice Location Address
First Line	:	8070 PARK LN
Second Line	:	SUITE 109
City	:	DALLAS
State	:	TX
Zip	:	75231-5906
Country	:	US
Telephone Number	:	214-346-0260
Fax Number	:	214-346-0261

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

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	10/29/2008

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