| NPI | 1851450969 |
|---|---|
| Other Name | SOUTHLAKE IMAGING CENTER |
| Entity Type | Organization |
| Authorized Contact | JOHN A QUERALT President 817-321-0312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging |
| 2085U0001X Radiology, Diagnostic Ultrasound | |
| 2085N0904X Radiology, Nuclear Radiology | |
| 2085P0229X Radiology, Pediatric Radiology | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2012-08-31 |