Organization · Type 2 NPI
Tidc-Grapevine, Inc
Diagnostic Radiology Physician · Grapevine, TX
NPI number
1689639205
Active
Practice location
5311 William D Tate Ave
Grapevine, TX 76051-7365
Fax (817) 545-9400
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Diagnostic Radiology Physician Primary | 2085R0202X | R22410 (TX) |
Diagnostic Radiology Physician: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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About NPI 1689639205
Tidc-Grapevine, Inc's National Provider Identifier is 1689639205, issued on Apr 18, 2006. The primary taxonomy on file is Diagnostic Radiology Physician (2085R0202X), and the practice location is in Grapevine, TX. The record was last updated on Sep 19, 2007.