Provider Demographics
NPI:1326225707
Name:PARK CENTRAL IMAGING LLC
Entity Type:Organization
Organization Name:PARK CENTRAL IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SAKURADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-479-1115
Mailing Address - Street 1:5601 GRANITE PKWY
Mailing Address - Street 2:STE 460
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-6654
Mailing Address - Country:US
Mailing Address - Phone:469-362-6909
Mailing Address - Fax:
Practice Address - Street 1:5601 GRANITE PKWY
Practice Address - Street 2:STE 460
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-6654
Practice Address - Country:US
Practice Address - Phone:469-362-6909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance ImagingGroup - Multi-Specialty
No2471C3401XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistComputed TomographyGroup - Multi-Specialty