MEDICARE: PREFERRED IMAGING AT THE MEDICAL CENTER LTD

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	2471M1202X	Magnetic Resonance Imaging Radiologic Technologist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00237806	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	FTXU46	OTHER	TX	BCBS TX
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992880827
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREFERRED IMAGING AT THE MEDICAL CENTER LTD

Provider Business Mailing Address
First Line	:	PO BOX 674056
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75267-4056
Country	:	US
Telephone Number	:	972-479-1115
Fax Number	:	972-479-1118

Provider Business Practice Location Address
First Line	:	5920 FOREST PARK RD.
Second Line	:	STE 560
City	:	DALLAS
State	:	TX
Zip	:	75235-6400
Country	:	US
Telephone Number	:	214-350-0708
Fax Number	:	214-764-3073

Authorized Official
Title or Position	:	DIRECTOR OF NETWORK DEVELOPMENT
Name	:	CLERISSA HADLEY
Credential	:
Telephone Number	:	972-215-7410

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	01/19/2018

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Directions to “PREFERRED IMAGING AT THE MEDICAL CENTER LTD ” Practice Location

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