Provider Demographics
NPI:1649442112
Name:DIAGNOSTIC IMAGING SPECIALISTS, LTD
Entity type:Organization
Organization Name:DIAGNOSTIC IMAGING SPECIALISTS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JO
Authorized Official - Middle Name:
Authorized Official - Last Name:GIANCOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-724-0100
Mailing Address - Street 1:1435 S LOOP 288
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-4701
Mailing Address - Country:US
Mailing Address - Phone:940-320-6901
Mailing Address - Fax:940-320-6969
Practice Address - Street 1:1435 S LOOP 288
Practice Address - Street 2:SUITE 101
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-4701
Practice Address - Country:US
Practice Address - Phone:940-320-6901
Practice Address - Fax:940-320-6969
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IMAGING SPECIALISTS GROUP LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFTA048Medicare PIN