Provider Demographics
NPI:1003092883
Name:ADVANTECHS X-RAY IMAGING SERVICES, LLC
Entity Type:Organization
Organization Name:ADVANTECHS X-RAY IMAGING SERVICES, LLC
Other - Org Name:HARMONYCARES MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-824-6000
Mailing Address - Street 1:PO BOX 639295 DEPT 93410
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-9295
Mailing Address - Country:US
Mailing Address - Phone:800-759-7291
Mailing Address - Fax:855-618-6655
Practice Address - Street 1:4545 FULLER DR
Practice Address - Street 2:STE. 325
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-6530
Practice Address - Country:US
Practice Address - Phone:800-759-7291
Practice Address - Fax:248-824-0630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-11
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR28054335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX163031101Medicaid
459891OtherBCBS