Provider Demographics
NPI:1275860652
Name:CROWN IMAGING, LLC
Entity Type:Organization
Organization Name:CROWN IMAGING, LLC
Other - Org Name:CROWN IMAGING
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CLIFTON
Authorized Official - Middle Name:COLIN
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-759-5140
Mailing Address - Street 1:7515 GREENVILLE AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-3831
Mailing Address - Country:US
Mailing Address - Phone:972-759-5140
Mailing Address - Fax:972-759-5150
Practice Address - Street 1:7515 GREENVILLE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3831
Practice Address - Country:US
Practice Address - Phone:972-759-5140
Practice Address - Fax:972-759-5150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-05
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology