Provider Demographics
NPI:1104325083
Name:MEDICAL DIAGNOSTIC SERVICES, PLLC
Entity type:Organization
Organization Name:MEDICAL DIAGNOSTIC SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCAULIFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-453-0300
Mailing Address - Street 1:190 E STACY RD STE 306-228
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-8734
Mailing Address - Country:US
Mailing Address - Phone:469-453-0300
Mailing Address - Fax:469-250-1273
Practice Address - Street 1:190 E STACY RD STE 306-228
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-8734
Practice Address - Country:US
Practice Address - Phone:469-250-0273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-06
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty