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INDEPENDENT MOBIL DIAGNOSTICE TESTING FACILITY NPI 1437434206


NPI Information

NPI: 1437434206
Provider Name: INDEPENDENT MOBIL DIAGNOSTICE TESTING FACILITY
Classification: Preferred Provider Organization - 305R00000X
Entity Type: Organization
Address:
1661 WOODARD AVE
SUITE 110
CLEBURNE, TX
ZIP 76033
Phone: (817) 494-6875
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INDEPENDENT MOBIL DIAGNOSTICE TESTING FACILITY is a preferred provider organization in Cleburne, TX. The provider is a group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. INDEPENDENT MOBIL DIAGNOSTICE TESTING FACILITY NPI is 1437434206. The provider is registered as an organization entity type.

The provider's business location address is:

1661 WOODARD AVE
SUITE 110
CLEBURNE, TX
ZIP 76033-052
Phone: (817) 494-6875

The provider's authorized official is Edmond S Maxon .
The authorized official title is Ed and has the following contact phone number (817) 494-6875.

The enumeration date for this NPI number is 10/12/2011 and was last updated on 10/12/2011.


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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1320600000XResidential Treatment Facility, Intellectual and/or Developmental Disabilities22799TEXASNo
2305R00000XPreferred Provider Organization22799TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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