Provider Demographics
NPI:1033174701
Name:NORTH STAR MRI LP
Entity Type:Organization
Organization Name:NORTH STAR MRI LP
Other - Org Name:NORTH STAR DIAGNOSTIC IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SASKIW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-649-6460
Mailing Address - Street 1:7600 WINDROSE AVE STE G325
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-0108
Mailing Address - Country:US
Mailing Address - Phone:972-649-6460
Mailing Address - Fax:972-649-6461
Practice Address - Street 1:997 RAINTREE CIRCLE
Practice Address - Street 2:SUITE 110
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-4952
Practice Address - Country:US
Practice Address - Phone:972-954-8001
Practice Address - Fax:972-954-8008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-18
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167090301Medicaid
TX167090301Medicaid