RADIOLOGY ASSOCIATES OF NORTH TEXAS PA NPI 1417017195

NPI Information

RADIOLOGY ASSOCIATES OF NORTH TEXAS PA is a diagnostic ultrasound radiology in Fort Worth, TX. The provider is a Radiology doctor of Osteopathy that specializes in Diagnostic Ultrasound. RADIOLOGY ASSOCIATES OF NORTH TEXAS PA NPI is 1417017195. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Pennsylvania Avenue Imaging Center.

The provider's business location address is:

815 PENNSYLVANIA AVE
FORT WORTH, TX
ZIP 76104-224
Phone: (817) 321-0312
Fax: (817) 317-7033

The provider's authorized official is John A Queralt .
The authorized official title is President and has the following contact phone number (817) 321-0312.

The CLIA number assigned to this NPI record is 45D2130188 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/11/2006 and was last updated on 8/31/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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