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NPI Code Detail

MEDICARE: ASHLEY NICHOLE JAMES BSRS, RVT, RDMS

MEDICARE: ASHLEY NICHOLE JAMES BSRS, RVT, RDMS
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
12471V0105XVascular Sonography Radiologic Technologist129945
22471S1302XSonography Radiologic Technologist129945

General Provider Information

NPI Number : 1831867290
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY NICHOLE JAMES BSRS, RVT, RDMS
Provider Business Mailing Address
First Line : 6341 HUNTERS GLEN DR
Second Line :
City : WATAUGA
State : TX
Zip : 76148-1319
Country : US
Telephone Number : 817-657-7509
Fax Number :
Provider Business Practice Location Address
First Line : 1800 PARK PLACE AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76110-1302
Country : US
Telephone Number : 682-703-5600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2021
Last Update Date : 09/01/2021

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