Provider Demographics
NPI:1245413319
Name:DENNIS WHITSELL
Entity Type:Organization
Organization Name:DENNIS WHITSELL
Other - Org Name:PDQ MOBILE XRAY
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER /OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:DEE
Authorized Official - Last Name:WHITSELL
Authorized Official - Suffix:
Authorized Official - Credentials:RT
Authorized Official - Phone:254-893-5181
Mailing Address - Street 1:391 COUNTY ROAD 473
Mailing Address - Street 2:
Mailing Address - City:DE LEON
Mailing Address - State:TX
Mailing Address - Zip Code:76444-6221
Mailing Address - Country:US
Mailing Address - Phone:254-893-5181
Mailing Address - Fax:877-879-7379
Practice Address - Street 1:391 COUNTY ROAD 473
Practice Address - Street 2:
Practice Address - City:DE LEON
Practice Address - State:TX
Practice Address - Zip Code:76444-6221
Practice Address - Country:US
Practice Address - Phone:254-893-5181
Practice Address - Fax:877-879-7379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX129812471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiographyGroup - Single Specialty