Provider Demographics
NPI:1942489125
Name:ADVANCED MEDICAL IMAGING OF NORTH TEXAS LP
Entity Type:Organization
Organization Name:ADVANCED MEDICAL IMAGING OF NORTH TEXAS LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HENSLEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-465-9508
Mailing Address - Street 1:PO BOX 1720
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75091-1720
Mailing Address - Country:US
Mailing Address - Phone:903-465-9508
Mailing Address - Fax:903-327-8023
Practice Address - Street 1:2622 NORTH US HIGHWAY 75
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090
Practice Address - Country:US
Practice Address - Phone:903-868-8730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Z328Medicare PIN