Provider Demographics
NPI:1033341839
Name:MDS DIGITAL X-RAY INC
Entity Type:Organization
Organization Name:MDS DIGITAL X-RAY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAMS
Authorized Official - Middle Name:U
Authorized Official - Last Name:SIDDIQUI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-626-0800
Mailing Address - Street 1:565 W OATES RD
Mailing Address - Street 2:STE 100A
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-5463
Mailing Address - Country:US
Mailing Address - Phone:972-270-1400
Mailing Address - Fax:972-270-1404
Practice Address - Street 1:565 W OATES RD
Practice Address - Street 2:STE 100A
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-5463
Practice Address - Country:US
Practice Address - Phone:972-270-1400
Practice Address - Fax:972-270-1404
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MDS DIGITAL X-RAY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-08-13
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory