Provider Demographics
NPI:1740268226
Name:WATCH IMAGING LLP
Entity type:Organization
Organization Name:WATCH IMAGING LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ LEAD IMAGING TECHNOLOGIS
Authorized Official - Prefix:MR
Authorized Official - First Name:DYLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HINESLY
Authorized Official - Suffix:
Authorized Official - Credentials:RT (R), MRT
Authorized Official - Phone:806-698-6240
Mailing Address - Street 1:5737 147TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-6540
Mailing Address - Country:US
Mailing Address - Phone:806-698-6240
Mailing Address - Fax:866-665-4397
Practice Address - Street 1:5737 147TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-6540
Practice Address - Country:US
Practice Address - Phone:806-698-6240
Practice Address - Fax:866-665-4397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18927261QM1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXY08980Medicare UPIN
TXFTX145Medicare ID - Type UnspecifiedMEDICARE NUMBER