Provider Demographics
NPI:1740390335
Name:AMERICAN RADIOLOGY CONSULTANTS, PLLC
Entity Type:Organization
Organization Name:AMERICAN RADIOLOGY CONSULTANTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:FULMER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-826-8822
Mailing Address - Street 1:PO BOX 678253
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-8253
Mailing Address - Country:US
Mailing Address - Phone:800-945-2455
Mailing Address - Fax:903-453-2541
Practice Address - Street 1:10644 INDIGO BROOM LOOP
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78755
Practice Address - Country:US
Practice Address - Phone:800-945-2455
Practice Address - Fax:903-453-2541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00X021Medicare PIN