Provider Demographics
NPI:1063528461
Name:RADIOLOGY ASSOCIATES OF DENISON, LLP
Entity type:Organization
Organization Name:RADIOLOGY ASSOCIATES OF DENISON, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRACTICE MGR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HENSLEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-465-9508
Mailing Address - Street 1:1302 HWY 91 NORTH
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020
Mailing Address - Country:US
Mailing Address - Phone:903-465-1857
Mailing Address - Fax:903-327-8023
Practice Address - Street 1:504 LIPSCOMB ST
Practice Address - Street 2:RADIOLOGY DEPT
Practice Address - City:BONHAM
Practice Address - State:TX
Practice Address - Zip Code:75418-4028
Practice Address - Country:US
Practice Address - Phone:903-583-8585
Practice Address - Fax:903-640-7601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX112627801Medicaid
TX112627801Medicaid