Provider Demographics
NPI:1811185226
Name:HIGHLANDS IMAGING CENTER LLC
Entity Type:Organization
Organization Name:HIGHLANDS IMAGING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:J
Authorized Official - Last Name:O'HEARN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-745-7601
Mailing Address - Street 1:270 N DENTON TAP RD STE 250
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-2159
Mailing Address - Country:US
Mailing Address - Phone:972-745-7601
Mailing Address - Fax:972-745-7606
Practice Address - Street 1:6020 LONG PRAIRIE RD STE 200
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2583
Practice Address - Country:US
Practice Address - Phone:972-874-9900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-10
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology