MEDICARE: NORTH TEXAS IMAGING CENTER

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	J4327	TX

General Provider Information

NPI Number	:	1861427221
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH TEXAS IMAGING CENTER

Provider Business Mailing Address
First Line	:	2301 S HAMPTON RD
Second Line	:	SUITE 100
City	:	DALLAS
State	:	TX
Zip	:	75224-1650
Country	:	US
Telephone Number	:	214-333-3600
Fax Number	:	214-467-1104

Provider Business Practice Location Address
First Line	:	2301 S HAMPTON RD
Second Line	:	SUITE 100
City	:	DALLAS
State	:	TX
Zip	:	75224-1650
Country	:	US
Telephone Number	:	214-333-3600
Fax Number	:	214-467-1104

Authorized Official
Title or Position	:	PROPRIETOR
Name	:	DEE LAWRENCE MARTINEZ III
Credential	:	M.D.
Telephone Number	:	214-333-3600

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	08/22/2020

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Directions to “NORTH TEXAS IMAGING CENTER ” Practice Location

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