Provider Demographics
NPI:1881840981
Name:IMAGDENT FW LLP
Entity Type:Organization
Organization Name:IMAGDENT FW LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:IMAGING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-731-9500
Mailing Address - Street 1:3880 HULEN ST
Mailing Address - Street 2:SUITE 660
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-7256
Mailing Address - Country:US
Mailing Address - Phone:817-731-9500
Mailing Address - Fax:
Practice Address - Street 1:3880 HULEN ST
Practice Address - Street 2:SUITE 660
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-7256
Practice Address - Country:US
Practice Address - Phone:817-731-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-08
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471C3401XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistComputed TomographyGroup - Single Specialty