Provider Demographics
NPI:1700841525
Name:RCA ADVANCED IMAGING LP
Entity Type:Organization
Organization Name:RCA ADVANCED IMAGING LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:LEIFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-420-5400
Mailing Address - Street 1:1750 N HAMPTON RD
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2306
Mailing Address - Country:US
Mailing Address - Phone:214-420-5400
Mailing Address - Fax:214-420-5401
Practice Address - Street 1:1750 N HAMPTON RD
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-2306
Practice Address - Country:US
Practice Address - Phone:214-420-5400
Practice Address - Fax:214-420-5401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-18
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX171610201Medicaid
TX00456YMedicare PIN
TXDE0477Medicare PIN