Organization · NPI-2

Dynamic X-Ray INC.

Radiologic Technologist · Dallas, TX

NPI number1811399678
StatusActive
Last updated in NPPESJun 20, 2018

Details

NPI
1811399678
Entity type
Organization (NPI-2)
Legal business name
Dynamic X-Ray INC.
Organization subpart
No
Enumeration date
Sep 23, 2014
Last updated
Jun 20, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
247100000X Radiologic Technologist–TXYes
246XS1301X Spec/Tech, Cardiovascular, Sonography–TX
2471C3402X Radiologic Technologist, Radiography–TX
2471V0105X Radiologic Technologist, Vascular Sonography–TX
2471S1302X Radiologic Technologist, Sonography–TX

Practice location

4230 Lbj Fwy
Ste, 111
Dallas, TX 75244-5806

Phone 972-352-7260

Mailing address

291 Stone Mountain Dr
Sunnyvale, TX 75182-2655

Phone 972-352-7260

Authorized official

Benny J. Illickal
Owner
9723527260

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