Provider Demographics
NPI:1487774717
Name:UNITED PARTNERS IN RADIOLOGY
Entity type:Organization
Organization Name:UNITED PARTNERS IN RADIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:FISK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-358-1111
Mailing Address - Street 1:9090 SKILLMAN ST # 182A
Mailing Address - Street 2:PMB 371
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243
Mailing Address - Country:US
Mailing Address - Phone:214-358-1111
Mailing Address - Fax:972-669-1557
Practice Address - Street 1:9090 SKILLMAN ST STE 182A
Practice Address - Street 2:PMB 371
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-8278
Practice Address - Country:US
Practice Address - Phone:214-358-1111
Practice Address - Fax:972-669-1557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9077208VP0014X, 2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiologyGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00651KMedicare PIN