Functional Imaging of Texas, PA

Organization Active NPI Nuclear Medicine Physician · Corinth, TX

NPI 1386659142 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1386659142
Entity type
Organization (NPI type 2)
Primary specialty
Nuclear Medicine Physician 207U00000X
Legal business name
FUNCTIONAL IMAGING OF TEXAS, PA
Practice address
4851 S Interstate 35 E
Ste 101
Corinth, TX 76210-2348
Phone
(972) 447-9799
NPI assigned
Jul 30, 2006
Organization subpart
No

Authorized official

Name
Dr. Theodore R. Simon, M.D.
Title
Executive Officer
Phone
(214) 435-2866

National Provider Directory

Locations

8345 Walnut Hill Ln
Ste 210
Dallas, TX 75231
Phone (214) 435-2866

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207U00000X Yes

Addresses

Primary practice location

4851 S Interstate 35 E
Ste 101
Corinth, TX 76210-2348

Mailing address

PO Box 650772
Dallas, TX 75265-0772
Phone (972) 447-9799

Other identifiers

IdentifierTypeStateIssuer
DD9838OtherTXMEDICARE RAILROAD
0076MGOtherTXBC/BS

Other providers in Corinth, TX

All providers in Corinth, TX · Nuclear Medicine Physician in Texas

Sources for this page

Verify at the official NPI Registry.