Provider Demographics
NPI:1346805777
Name:AMERICAN HEALTH IMAGING OF DALLAS, LLC
Entity Type:Organization
Organization Name:AMERICAN HEALTH IMAGING OF DALLAS, LLC
Other - Org Name:AMERICAN HEALTH IMAGING OF NEW BRAUNFELS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER OF CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:TRAVIS
Authorized Official - Last Name:LUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-362-5391
Mailing Address - Street 1:PO BOX 745973
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-5973
Mailing Address - Country:US
Mailing Address - Phone:404-296-5887
Mailing Address - Fax:404-297-5237
Practice Address - Street 1:625 CENTRAL PKWY
Practice Address - Street 2:UNIT 108
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-2193
Practice Address - Country:US
Practice Address - Phone:830-302-4222
Practice Address - Fax:830-302-4244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-01
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology