Provider Demographics
NPI:1770610685
Name:MID-CITIES IMAGING, L.P.
Entity type:Organization
Organization Name:MID-CITIES IMAGING, L.P.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARDELLE
Authorized Official - Middle Name:K
Authorized Official - Last Name:ARCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-498-1963
Mailing Address - Street 1:PO BOX 835885
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75083-5885
Mailing Address - Country:US
Mailing Address - Phone:972-498-1963
Mailing Address - Fax:972-498-1965
Practice Address - Street 1:1015 W RANDOL MILL RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-2513
Practice Address - Country:US
Practice Address - Phone:817-701-1306
Practice Address - Fax:682-367-1770
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MID-CITIES IMAGING, L.P.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-27
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR308112471M1202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance ImagingGroup - Single Specialty