Provider Demographics
NPI:1023391414
Name:PRIME DIAGNOSTIC IMAGING OF DUNCANVILLE LLC
Entity Type:Organization
Organization Name:PRIME DIAGNOSTIC IMAGING OF DUNCANVILLE LLC
Other - Org Name:PRIME DIAGNOSTIC IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HELLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-341-8770
Mailing Address - Street 1:12840 HILLCREST PLAZA DRIVE
Mailing Address - Street 2:SUITE E100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1034 E HIGHWAY 67
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75137-2704
Practice Address - Country:US
Practice Address - Phone:214-341-8770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology