MONTICELLO DIAGNOSTIC IMAGING CLEBURNE LP NPI 1639893639

NPI Information

  • NPI: 1639893639
  • Provider Name: MONTICELLO DIAGNOSTIC IMAGING CLEBURNE, LP
  • Classification: Clinic/Center - 261QR0200X
  • Specialization: Radiology
  • Entity Type: Organization
  • :
  • CLIA Number: 45D2279994
  • Address: 105 N RIDGEWAY CT
    CLEBURNE, TX
    ZIP 76033
  • Phone: (682) 317-9178

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NPI Details

MONTICELLO DIAGNOSTIC IMAGING CLEBURNE, LP is a radiology clinic center in Cleburne, TX. MONTICELLO DIAGNOSTIC IMAGING CLEBURNE, LP NPI is 1639893639. The provider is registered as an organization entity type and is a single specialty group.
The provider .

The provider's business location address is:

105 N RIDGEWAY CT
CLEBURNE, TX
ZIP 76033-180
Phone: (682) 317-9178

The provider's authorized official is Chelsea Mechelle Holder .
The authorized official title is Practice Administrator and has the following contact phone number (817) 377-3800.

The CLIA number assigned to this NPI record is 45D2279994 - other - imaging center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/3/2022 and was last updated on 2/10/2025.

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
12085R0202XRadiologyDiagnostic RadiologyNo
2261QR0200XClinic/CenterRadiologyYes
3293D00000XPhysiological LaboratoryNo

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: 3/30/2025

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