MEDICARE: JCORE MEDICAL DIAGNOSTICS, INC.

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	246ZE0600X	Electroneurodiagnostic Specialist/Technologist	627	TX
2	2471S1302X	Sonography Radiologic Technologist	95167	TX
3	2471V0105X	Vascular Sonography Radiologic Technologist	95167	TX

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	:	1801953468
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JCORE MEDICAL DIAGNOSTICS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 2072
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75034-0036
Country	:	US
Telephone Number	:	214-732-8165
Fax Number	:	866-261-1293

Provider Business Practice Location Address
First Line	:	7552 MAIN ST
Second Line	:	SUITE 202
City	:	THE COLONY
State	:	TX
Zip	:	75056-3448
Country	:	US
Telephone Number	:	214-732-8165
Fax Number	:	866-261-1293

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BRANDON COREY COLE
Credential	:	RDMS, RVT, RNCST
Telephone Number	:	214-732-8165

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	07/08/2010

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