| NPI | 1417017195 |
|---|---|
| Other Name | PENNSYLVANIA AVENUE IMAGING CENTER |
| Entity Type | Organization |
| Authorized Contact | JOHN A QUERALT President 817-321-0312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085U0001X Radiology Diagnostic Ultrasound |
| Additional Taxonomies | 2085B0100X Radiology Body Imaging |
| 2085N0700X Radiology Neuroradiology | |
| 2085N0904X Radiology Nuclear Radiology | |
| 2085P0229X Radiology Pediatric Radiology | |
| 2085R0202X Radiology Diagnostic Radiology | |
| 2085R0204X Radiology Vascular & Interventional Radiology | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2012-08-31 |