Provider Demographics
NPI:1245635648
Name:GREATER DALLAS RADIOLOGY ASSOCIATES PLLC
Entity type:Organization
Organization Name:GREATER DALLAS RADIOLOGY ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-514-6056
Mailing Address - Street 1:PO BOX 5460
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75608-5460
Mailing Address - Country:US
Mailing Address - Phone:903-663-7393
Mailing Address - Fax:903-663-7394
Practice Address - Street 1:9440 POPPY DR
Practice Address - Street 2:RADIOLOGY DEPARTMENT
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-3652
Practice Address - Country:US
Practice Address - Phone:214-324-6152
Practice Address - Fax:903-663-7394
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RIVER CITY IMAGING ASSOCIATES PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-28
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty