Provider Demographics
NPI:1356323562
Name:NUMED IMAGING CENTERS, INC
Entity Type:Organization
Organization Name:NUMED IMAGING CENTERS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING COORDINATOR/NETWORK MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-365-5700
Mailing Address - Street 1:PO BOX 1098
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76202-1098
Mailing Address - Country:US
Mailing Address - Phone:940-365-5700
Mailing Address - Fax:940-365-5077
Practice Address - Street 1:220 N PARK BLVD
Practice Address - Street 2:SUITE 112
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-6987
Practice Address - Country:US
Practice Address - Phone:817-421-2075
Practice Address - Fax:817-421-7724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-15
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL050162471N0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471N0900XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistNuclear Medicine TechnologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX087994201Medicaid
TXL05016OtherRADIOACTIVE LICENSE
TXFTA007Medicare ID - Type UnspecifiedPROVIDER NUMBER