Provider Demographics
NPI:1346505948
Name:IMAGE CONNECTION LLC
Entity Type:Organization
Organization Name:IMAGE CONNECTION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSALIND
Authorized Official - Middle Name:W
Authorized Official - Last Name:CIESLEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-422-1118
Mailing Address - Street 1:9337 SPRING CYPRESS RD
Mailing Address - Street 2:SUITE E-6
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-3484
Mailing Address - Country:US
Mailing Address - Phone:214-422-1118
Mailing Address - Fax:214-853-4235
Practice Address - Street 1:9337 SPRING CYPRESS RD
Practice Address - Street 2:SUITE E-6
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-3484
Practice Address - Country:US
Practice Address - Phone:214-422-1118
Practice Address - Fax:214-853-4235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-10
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology