Provider Demographics
NPI:1942577218
Name:FAMILY RADIOLOGY OF DENTON LLC
Entity Type:Organization
Organization Name:FAMILY RADIOLOGY OF DENTON LLC
Other - Org Name:CHART REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-955-0766
Mailing Address - Street 1:3843 KELLY BLVD
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-2051
Mailing Address - Country:US
Mailing Address - Phone:972-454-9386
Mailing Address - Fax:972-957-2621
Practice Address - Street 1:3843 KELLY BLVD
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-2051
Practice Address - Country:US
Practice Address - Phone:972-454-9386
Practice Address - Fax:972-957-2621
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY RADIOLOGY OF DENTON LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-11-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization