Provider Demographics
NPI:1609093368
Name:PRAIRIE HEALTH SERVICES, LLP
Entity Type:Organization
Organization Name:PRAIRIE HEALTH SERVICES, LLP
Other - Org Name:PRAIRIE IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAURENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:FRAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-282-9992
Mailing Address - Street 1:503 W HARWOOD RD
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-3163
Mailing Address - Country:US
Mailing Address - Phone:817-282-9992
Mailing Address - Fax:817-282-9993
Practice Address - Street 1:1301 OAKWOOD CT
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-3694
Practice Address - Country:US
Practice Address - Phone:469-867-1435
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)