Provider Demographics
NPI:1275865503
Name:NATIONAL RADIOLOGY GROUP-DFW P A
Entity Type:Organization
Organization Name:NATIONAL RADIOLOGY GROUP-DFW P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:615-986-6099
Mailing Address - Street 1:75 REMITTANCE DR
Mailing Address - Street 2:DEPT 6590
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60675-6590
Mailing Address - Country:US
Mailing Address - Phone:615-986-6099
Mailing Address - Fax:615-234-1522
Practice Address - Street 1:3201 W HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-2450
Practice Address - Country:US
Practice Address - Phone:903-654-6800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-11
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty