Provider Demographics
NPI:1710018023
Name:BLUE STAR IMAGING
Entity Type:Organization
Organization Name:BLUE STAR IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
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 1:1 COWBOYS PKWY
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-4924
Mailing Address - Country:US
Mailing Address - Phone:214-647-6161
Mailing Address - Fax:214-647-6162
Practice Address - Street 1:1 COWBOYS PKWY
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-4924
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:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTAX ID #