Provider Demographics
NPI:1922048388
Name:KNOTT SPEARS GROUP, INC
Entity Type:Organization
Organization Name:KNOTT SPEARS GROUP, INC
Other - Org Name:LONE STAR IMAGING & DIAGNOSTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPEARS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-261-6666
Mailing Address - Street 1:1119 W RANDOL MILL RD
Mailing Address - Street 2:# 104
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-6509
Mailing Address - Country:US
Mailing Address - Phone:817-261-6666
Mailing Address - Fax:817-261-6665
Practice Address - Street 1:1119 W RANDOL MILL RD
Practice Address - Street 2:# 104
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-6509
Practice Address - Country:US
Practice Address - Phone:817-261-6666
Practice Address - Fax:817-261-6665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFTX102Medicare ID - Type Unspecified