Provider Demographics
NPI:1942289855
Name:PLANO RADIOLOGY CENTER LTD
Entity Type:Organization
Organization Name:PLANO RADIOLOGY CENTER LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:A
Authorized Official - Last Name:POSADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-361-2930
Mailing Address - Street 1:PO BOX 797307
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75379-7307
Mailing Address - Country:US
Mailing Address - Phone:972-312-9944
Mailing Address - Fax:972-312-9962
Practice Address - Street 1:3060 COMMUNICATIONS PKWY
Practice Address - Street 2:SUITE 103
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8449
Practice Address - Country:US
Practice Address - Phone:972-312-9944
Practice Address - Fax:972-312-9962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-10
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR29511174400000X, 261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1753766Medicaid
TX1753766Medicaid