Provider Demographics
NPI:1780611038
Name:TOUCHSTONE IMAGING OF TYLER, LP
Entity type:Organization
Organization Name:TOUCHSTONE IMAGING OF TYLER, LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:RICE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:615-661-9200
Mailing Address - Street 1:PO BOX 116484
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-6484
Mailing Address - Country:US
Mailing Address - Phone:615-661-9200
Mailing Address - Fax:615-661-9297
Practice Address - Street 1:1904 E SOUTHEAST LOOP 323
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-8337
Practice Address - Country:US
Practice Address - Phone:903-526-6736
Practice Address - Fax:903-526-7911
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOUCHSTONE MEDICAL IMAGING, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-26
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX088050202Medicaid
TX194747501Medicaid
TXFTA102Medicare PIN