Provider Demographics
NPI:1073080875
Name:NORTH TEXAS ADVANCED IMAGING LLC
Entity Type:Organization
Organization Name:NORTH TEXAS ADVANCED IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERESITA
Authorized Official - Middle Name:EMILIA
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-473-2700
Mailing Address - Street 1:6160 WINDHAVEN PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-2143
Mailing Address - Country:US
Mailing Address - Phone:972-473-2700
Mailing Address - Fax:
Practice Address - Street 1:6160 WINDHAVEN PKWY STE 100
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-2143
Practice Address - Country:US
Practice Address - Phone:972-473-2700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)