Provider Demographics
NPI:1336033752
Name:TEXAS DIAGNOSTIC RADIOLOGY PA
Entity type:Organization
Organization Name:TEXAS DIAGNOSTIC RADIOLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:WARONKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-831-6640
Mailing Address - Street 1:1606 HEADWAY CIR STE 19038
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754-5123
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1606 HEADWAY CIR STE 19038
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754-5123
Practice Address - Country:US
Practice Address - Phone:214-831-6640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology