Provider Demographics
NPI:1538305214
Name:BLUE STAR IMAGING, II, L.P.
Entity Type:Organization
Organization Name:BLUE STAR IMAGING, II, L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:RAE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGARRITY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-647-6161
Mailing Address - Street 1:3000 CORPORATE CT
Mailing Address - Street 2:SUITE 400
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-2299
Mailing Address - Country:US
Mailing Address - Phone:214-647-6161
Mailing Address - Fax:214-647-6162
Practice Address - Street 1:3000 CORPORATE CT
Practice Address - Street 2:SUITE 400
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2299
Practice Address - Country:US
Practice Address - Phone:214-647-6161
Practice Address - Fax:214-647-6162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-30
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFTXUV2Medicare UPIN