Provider Demographics
NPI:1952655607
Name:IHEART CVM I, LLC
Entity Type:Organization
Organization Name:IHEART CVM I, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:TAYCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-244-9820
Mailing Address - Street 1:17950 PRESTON RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-5793
Mailing Address - Country:US
Mailing Address - Phone:214-253-0390
Mailing Address - Fax:214-253-0394
Practice Address - Street 1:17950 PRESTON RD
Practice Address - Street 2:SUITE 120
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252-5793
Practice Address - Country:US
Practice Address - Phone:214-253-0390
Practice Address - Fax:214-253-0394
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IHEART, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-02
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)