Provider Demographics
NPI:1497191852
Name:MRI CENTERS OF TEXAS LLC-PRESTON SERIES
Entity Type:Organization
Organization Name:MRI CENTERS OF TEXAS LLC-PRESTON SERIES
Other - Org Name:MID CITIES IMAGING, LP
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ARDELLE
Authorized Official - Middle Name:K
Authorized Official - Last Name:ARCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-498-1963
Mailing Address - Street 1:PO BOX 224852
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75222-4852
Mailing Address - Country:US
Mailing Address - Phone:817-226-1800
Mailing Address - Fax:817-226-1802
Practice Address - Street 1:12800 PRESTON RD
Practice Address - Street 2:SUITE 120
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1365
Practice Address - Country:US
Practice Address - Phone:817-226-1800
Practice Address - Fax:817-226-1802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-13
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXR30811OtherCERTIFICATE OF X-RAY REGRISTRATION