MEDICARE: NORTH DALLAS MEDICAL 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	261QR0200X	Radiology Clinic/Center

General Provider Information

NPI Number	:	1760401699
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH DALLAS MEDICAL IMAGING

Provider Business Mailing Address
First Line	:	12800 PRESTON RD
Second Line	:	SUITE 100
City	:	DALLAS
State	:	TX
Zip	:	75230-1365
Country	:	US
Telephone Number	:	972-458-6888
Fax Number	:	469-916-6432

Provider Business Practice Location Address
First Line	:	12800 PRESTON RD
Second Line	:	SUITE 100
City	:	DALLAS
State	:	TX
Zip	:	75230-1365
Country	:	US
Telephone Number	:	972-458-6888
Fax Number	:	469-916-6432

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MIKE GHANI
Credential	:
Telephone Number	:	972-458-6888

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	08/22/2020

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Directions to “NORTH DALLAS MEDICAL IMAGING ” Practice Location

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