Provider Demographics
NPI:1063415008
Name:ARLINGTON MEDICAL IMAGING LLC
Entity type:Organization
Organization Name:ARLINGTON MEDICAL IMAGING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJESH
Authorized Official - Middle Name:
Authorized Official - Last Name:GOGIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-502-8157
Mailing Address - Street 1:2140 E SOUTHLAKE BLVD
Mailing Address - Street 2:L-426
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6516
Mailing Address - Country:US
Mailing Address - Phone:214-502-8157
Mailing Address - Fax:
Practice Address - Street 1:3025 MATLOCK RD
Practice Address - Street 2:STE 100
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-2902
Practice Address - Country:US
Practice Address - Phone:817-467-6099
Practice Address - Fax:972-739-1468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
No293D00000XLaboratoriesPhysiological LaboratoryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX154830702Medicaid
TX361995901Medicaid
TX566958Medicare PIN
TX411687Medicare PIN
TX361995901Medicaid