Provider Demographics
NPI:1265745632
Name:BLUE STAR RADIOLOGY ASSOCIATES
Entity type:Organization
Organization Name:BLUE STAR RADIOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-647-6165
Mailing Address - Street 1:3000 CORPORATE CT
Mailing Address - Street 2:SUITE 400
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-2299
Mailing Address - Country:US
Mailing Address - Phone:214-647-6165
Mailing Address - Fax:214-647-6166
Practice Address - Street 1:3000 CORPORATE CT
Practice Address - Street 2:SUITE 400
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-2299
Practice Address - Country:US
Practice Address - Phone:214-647-6165
Practice Address - Fax:214-647-6166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-14
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty