Provider Demographics
NPI:1831654383
Name:ADAMS, BYRON (RT (R))
Entity Type:Individual
Prefix:MR
First Name:BYRON
Middle Name:
Last Name:ADAMS
Suffix:
Gender:M
Credentials:RT (R)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 MISTY GLEN DR
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-4406
Mailing Address - Country:US
Mailing Address - Phone:972-704-4090
Mailing Address - Fax:
Practice Address - Street 1:808 MISTY GLEN DR
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-4406
Practice Address - Country:US
Practice Address - Phone:972-704-4090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXGMR001066732085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Single Specialty