Provider Demographics
NPI:1922034602
Name:CONSULTANTS IN RADIOLOGY PA
Entity Type:Organization
Organization Name:CONSULTANTS IN RADIOLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:M
Authorized Official - Last Name:HARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-218-9368
Mailing Address - Street 1:PO BOX 208509
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75320-8509
Mailing Address - Country:US
Mailing Address - Phone:817-200-7581
Mailing Address - Fax:
Practice Address - Street 1:1845 PRECINCT LINE RD
Practice Address - Street 2:STE. 209
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-3179
Practice Address - Country:US
Practice Address - Phone:817-200-7581
Practice Address - Fax:817-336-7637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX112624501Medicaid
P00867267OtherMEDICARE RR
P00867267OtherMEDICARE RR