MEDICARE: BREAST DIAGNOSTICS , PA

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	174400000X	Specialist	L5600	TX

General Provider Information

NPI Number	:	1942405436
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BREAST DIAGNOSTICS , PA

Provider Business Mailing Address
First Line	:	1545 E SOUTHLAKE BLVD
Second Line	:	STE 200
City	:	SOUTHLAKE
State	:	TX
Zip	:	76092-6422
Country	:	US
Telephone Number	:	817-749-2000
Fax Number	:	817-749-2000

Provider Business Practice Location Address
First Line	:	2817 S MAYHILL RD
Second Line	:	STE 270
City	:	DENTON
State	:	TX
Zip	:	76208-5966
Country	:	US
Telephone Number	:	940-483-9500
Fax Number	:	940-483-9550

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PRIYA VENUGOPAL
Credential	:	MD
Telephone Number	:	940-483-9550

Provider Enumeration Date	:	06/15/2007
Last Update Date	:	08/22/2020

Similar Medicare Providers

1538119110 — DR. LORI JAN MAY-MALONE MD
Practice Location Address:

2817 S MAYHILL RD , STE 270
DENTON, TX
76208-5966

Practice Phone: 940-483-9500
Practice Fax: 940-483-9550

1588607592 — RONALD DEJONG D.C.
Practice Location Address:

2817 S MAYHILL RD , SUITE 100
DENTON, TX
76208-5966

Practice Phone: 972-608-5000
Practice Fax: 972-608-5020

1346283348 — MICHAEL SCOTT HISEY M.D.
Practice Location Address:

2817 S MAYHILL RD , SUITE 100
DENTON, TX
76208-5966

Practice Phone: 972-608-5000
Practice Fax: 972-608-5020

1447364468 — DR. LAURIE ANNE ATEN MD
Practice Location Address:

2817 S MAYHILL RD , SUITE 230
DENTON, TX
76208-5966

Practice Phone: 940-220-0887
Practice Fax: 940-220-0893

1063524098 — JAMES A HALEY M.D. P.A.
Practice Location Address:

2817 S MAYHILL RD , SUITE 120
DENTON, TX
76208-5966

Practice Phone: 940-382-0900
Practice Fax: 940-565-9969

1932340809 — RONALD DE JONG DC PC
Practice Location Address:

2817 S MAYHILL RD , STE. 100
DENTON, TX
76208-5966

Practice Phone: 940-387-0474
Practice Fax: 940-387-0547

Directions to “BREAST DIAGNOSTICS , PA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.