MEDICARE: MOBILE DIAGNOSTIC SYSTEMS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	293D00000X	Physiological Laboratory
2	261QR0208X	Mobile Radiology Clinic/Center
3	261QR0200X	Radiology Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0084DC	OTHER		BCBS OF TEXAS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922001080
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBILE DIAGNOSTIC SYSTEMS, INC.

Provider Business Mailing Address
First Line	:	5055 KELLER SPRINGS RD
Second Line	:	STE 500
City	:	ADDISON
State	:	TX
Zip	:	75001-6220
Country	:	US
Telephone Number	:	214-242-8500
Fax Number	:	214-242-8600

Provider Business Practice Location Address
First Line	:	5055 KELLER SPRINGS RD
Second Line	:	STE 500
City	:	ADDISON
State	:	TX
Zip	:	75001-6220
Country	:	US
Telephone Number	:	214-242-8500
Fax Number	:	214-242-8600

Authorized Official
Title or Position	:	CEO
Name	:	CHRISTOPHER TURNER
Credential	:
Telephone Number	:	214-242-8500

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	07/27/2009

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