Provider Demographics
NPI:1699723338
Name:DIAGNOSTIC HEALTH CENTERS OF TEXAS LIMITED PARTNERSHIP
Entity type:Organization
Organization Name:DIAGNOSTIC HEALTH CENTERS OF TEXAS LIMITED PARTNERSHIP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL STAFF AFFAIRS/CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BURCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-981-4814
Mailing Address - Street 1:22 INVERNESS PARKWAY
Mailing Address - Street 2:SUITE 425
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-4980
Mailing Address - Country:US
Mailing Address - Phone:205-981-4814
Mailing Address - Fax:205-994-7021
Practice Address - Street 1:1717 PRECINCT LINE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-3169
Practice Address - Country:US
Practice Address - Phone:817-498-6575
Practice Address - Fax:817-498-8854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-05
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFTA129Medicare PIN