Provider Demographics
NPI:1235135898
Name:D2 IMAGING
Entity Type:Organization
Organization Name:D2 IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:C
Authorized Official - Last Name:LADNER
Authorized Official - Suffix:
Authorized Official - Credentials:RDMS, RVT
Authorized Official - Phone:817-921-6015
Mailing Address - Street 1:6320 SOUTHWEST BLVD
Mailing Address - Street 2:STE 104
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-3961
Mailing Address - Country:US
Mailing Address - Phone:817-921-6015
Mailing Address - Fax:817-763-9492
Practice Address - Street 1:6320 SOUTHWEST BLVD
Practice Address - Street 2:STE 104
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-3961
Practice Address - Country:US
Practice Address - Phone:817-921-6015
Practice Address - Fax:817-763-9492
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFTVUC2Medicare ID - Type Unspecified