MEDICARE: KRISTEN ALLISON BISHOP MD

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	2085R0202X	Diagnostic Radiology Physician	M5058	TX

General Provider Information

NPI Number	:	1942404132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN ALLISON BISHOP MD

Provider Business Mailing Address
First Line	:	5323 HARRY HINES BLVD
Second Line	:	RADIOLOGY GROUND FLOOR
City	:	DALLAS
State	:	TX
Zip	:	75390-8896
Country	:	US
Telephone Number	:	214-590-0066
Fax Number	:

Provider Business Practice Location Address
First Line	:	5323 HARRY HINES BLVD
Second Line	:	RADIOLOGY GROUND FLOOR
City	:	DALLAS
State	:	TX
Zip	:	75390-8896
Country	:	US
Telephone Number	:	214-590-0066
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2007
Last Update Date	:	03/24/2011

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