1205861895 NPI number — LONGVIEW DIAGNOSTIC IMAGING, LTD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205861895 NPI number — LONGVIEW DIAGNOSTIC IMAGING, LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LONGVIEW DIAGNOSTIC IMAGING, LTD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205861895
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/15/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PARIS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75461-0100
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
903-785-5421
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1010 N 6TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LONGVIEW
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75601-5534
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-757-9596
Provider Business Practice Location Address Fax Number:
903-757-0513
Provider Enumeration Date:
07/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CLIFFORD
Authorized Official First Name:
PHILIP
Authorized Official Middle Name:
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
903-757-9596

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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