Provider Demographics
NPI:1043501745
Name:MEADOW MEDICAL SERVICES L.L.C
Entity Type:Organization
Organization Name:MEADOW MEDICAL SERVICES L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDRZEJEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-884-4400
Mailing Address - Street 1:10400 N CENTRAL EXPY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-2297
Mailing Address - Country:US
Mailing Address - Phone:972-884-4322
Mailing Address - Fax:
Practice Address - Street 1:10400 N CENTRAL EXPY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-2297
Practice Address - Country:US
Practice Address - Phone:972-884-4322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-28
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX801416599261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)