Provider Demographics
NPI:1164425773
Name:OPEN MRI OF DALLAS, L.C.
Entity Type:Organization
Organization Name:OPEN MRI OF DALLAS, L.C.
Other - Org Name:NYDIC OPEN MRI OF AMERICA-DALLAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BUCHWALTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-573-8080
Mailing Address - Street 1:100 PARAGON DR
Mailing Address - Street 2:STE 200
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-1718
Mailing Address - Country:US
Mailing Address - Phone:201-573-8080
Mailing Address - Fax:201-775-4306
Practice Address - Street 1:8131 LBJ FWY
Practice Address - Street 2:STE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-1311
Practice Address - Country:US
Practice Address - Phone:972-231-7979
Practice Address - Fax:972-231-9988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Not Answered261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4515729OtherAETNA US HEALTHCARE
TXZ000N95T2Medicaid
TX614622OtherAETNA US HEALTHCARE HMO
TX16-50184OtherUNITED HEALTHCARE
TX16863OtherNYLCARE HEALTH PLANS
TX797933OtherFIRST HEALTH NETWORK
TX0726388OtherAMERIHEALTH
TX0025DCOtherBCBS OF TEXAS
TX3649OtherMEDFOCUS
TX825241OtherHEALTH SMART PREFERRED
TX4515729OtherAETNA US HEALTHCARE
TX16-50184OtherUNITED HEALTHCARE
TX16863OtherNYLCARE HEALTH PLANS