Provider Demographics
NPI:1275539231
Name:AMERICAN HEALTH IMAGING OF DALLAS LLC
Entity Type:Organization
Organization Name:AMERICAN HEALTH IMAGING OF DALLAS LLC
Other - Org Name:MRI CENTRAL PEARLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:ARANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-296-5887
Mailing Address - Street 1:PO BOX 933367
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31193
Mailing Address - Country:US
Mailing Address - Phone:404-296-5887
Mailing Address - Fax:
Practice Address - Street 1:10223 BROADWAY ST
Practice Address - Street 2:SUITE J
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-8417
Practice Address - Country:US
Practice Address - Phone:832-327-4674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-23
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFTX212Medicare PIN