1891747572 NPI number — TOUCHSTONE IMAGING OF MESQUITE, LP

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 1891747572 NPI number — TOUCHSTONE IMAGING OF MESQUITE, LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOUCHSTONE IMAGING OF MESQUITE, LP
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:
1891747572
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/06/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 116662
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30368-6662
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-216-4411
Provider Business Mailing Address Fax Number:
972-216-7346

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1425 GROSS RD
Provider Second Line Business Practice Location Address:
SUITE130
Provider Business Practice Location Address City Name:
MESQUITE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75149-1363
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-289-5558
Provider Business Practice Location Address Fax Number:
972-289-5786
Provider Enumeration Date:
05/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
RICE
Authorized Official First Name:
CHRISTIAN
Authorized Official Middle Name:
C.
Authorized Official Title or Position:
CHEIF MANAGER
Authorized Official Telephone Number:
615-661-9200

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  45D0972694 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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