Provider Demographics
NPI:1225462567
Name:EVOLUTION MOBILE IMAGING, LLC
Entity type:Organization
Organization Name:EVOLUTION MOBILE IMAGING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-754-8700
Mailing Address - Street 1:13737 NOEL RD
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-1331
Mailing Address - Country:US
Mailing Address - Phone:214-754-8700
Mailing Address - Fax:877-614-6192
Practice Address - Street 1:512 N WALNUT ST
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-4953
Practice Address - Country:US
Practice Address - Phone:903-819-3206
Practice Address - Fax:903-893-6737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-22
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR37465335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier