Diagnostic Pavilion
LBN: Ged Medical Management Inc
Diagnostic Pavilion is an health care organization with primary practice located at 2001 Cooper Street , Fort Worth TX 76104. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Magnetic Resonance Imaging (MRI), Ambulatory Health Care Facilities / Radiology. Ambulatory Health Care Facilities / Magnetic Resonance Imaging (MRI) is the primary health care specialty.
Ged Medical Management Inc can be contacted via phone (817) 877-3054, or through Ettinger, Alan Ira via phone (817) 877-3054.
Contact Information
Primary practice address
2001 Cooper Street
Fort Worth TX 76104
Phone: (817) 877-3054
Fax: (817) 546-0851
Website:
Authorized official contact:
Name: Ettinger, Alan Ira Doctor of Podiatric Medicine (DPM)
Phone: (817) 877-3054
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Magnetic Resonance Imaging (MRI) | 261QM1200X | ||
| Ambulatory Health Care Facilities / Radiology | 261QR0200X | R29901 | Texas |
Profile Details
| NPI number | 1942424452 |
|---|---|
| LBN Legal business name | Ged Medical Management Inc |
| DBA Doing business as | Diagnostic Pavilion |
| Authorized official | Ettinger, Alan Ira Doctor of Podiatric Medicine (DPM) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Apr 13th, 2007 |
| Last updated | Mar 5th, 2012 - about 12 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942424452 | NPPES |
| Texas | Other | 0533DC | BLUE CROSS PROVIDER NUMBE |
| Texas | Other | R29901 | BLUE CROSS PROVIDER NUMBE |
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