Provider Demographics
NPI:1740373497
Name:MDIAGNOSTICS
Entity type:Organization
Organization Name:MDIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CAMERON
Authorized Official - Middle Name:C
Authorized Official - Last Name:CALHOUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-838-1200
Mailing Address - Street 1:3500 N. CAUSEWAY BLVD
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002
Mailing Address - Country:US
Mailing Address - Phone:504-838-1200
Mailing Address - Fax:504-838-1239
Practice Address - Street 1:2701 S. HAMPTON RD
Practice Address - Street 2:SUITE 150
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75224
Practice Address - Country:US
Practice Address - Phone:214-339-8200
Practice Address - Fax:214-339-2807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFTA029Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
TXFTX108Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER