Provider Demographics
NPI:1790767101
Name:NUMED IMAGING CENTERS INC
Entity Type:Organization
Organization Name:NUMED IMAGING CENTERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING COORDINATOR/NETWORK MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-365-5700
Mailing Address - Street 1:PO BOX 1098
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76202-1098
Mailing Address - Country:US
Mailing Address - Phone:940-365-5700
Mailing Address - Fax:940-365-5077
Practice Address - Street 1:505 W RIDGEWAY
Practice Address - Street 2:SUITE 280
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033
Practice Address - Country:US
Practice Address - Phone:817-645-6856
Practice Address - Fax:817-645-7854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-19
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL057622471N0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471N0900XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistNuclear Medicine TechnologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX470000228OtherRR MCR NUMBER
TXL05762OtherRADIOACTIVE LICENSE
TX0396DCOtherBCBS PROV.NUMBER
TX087994201Medicaid
TXL05762OtherRADIOACTIVE LICENSE