SOUTHLAKE TROPHY CLUB RADIOLOGY NPI 1568403046

NPI Information

NPI: 1568403046
Provider Name: SOUTHLAKE TROPHY CLUB RADIOLOGY
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
2800 SOUTH HIGHWAY 114
TROPHY CLUB, TX
ZIP 76726
Phone: (817) 908-7810
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SOUTHLAKE TROPHY CLUB RADIOLOGY is a diagnostic radiology radiology in Trophy Club, TX. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. SOUTHLAKE TROPHY CLUB RADIOLOGY NPI is 1568403046. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2800 SOUTH HIGHWAY 114
TROPHY CLUB, TX
ZIP 76726
Phone: (817) 908-7810
Fax: (206) 337-0544

The provider's authorized official is Sarah Khan .
The authorized official title is Radiologist and has the following contact phone number (817) 908-7810.

The enumeration date for this NPI number is 6/8/2006 and was last updated on 11/1/2011.

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
1	2085R0202X	Radiology	Diagnostic Radiology	L1091	TEXAS	Yes

Other Identifiers

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

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	G67126	MEDICARE UPIN	TEXAS

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: 11/14/2023

NPI Synchronization or Removal

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