| NPI | 1811399678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENNY J. ILLICKAL Owner 972-352-7260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 247100000X Radiologic Technologist |
| Additional Taxonomies | 246XS1301X Spec/Tech, Cardiovascular, Sonography |
| 2471C3402X Radiologic Technologist, Radiography | |
| 2471V0105X Radiologic Technologist, Vascular Sonography | |
| 2471S1302X Radiologic Technologist, Sonography | |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2018-06-20 |