NPIMap

Organization Active NPI

Stat X-Ray of Texas Inc

  • Radiologic Technologist
  • Mesquite, TX
National Provider Identifier
1417052002
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiologic TechnologistTaxonomy code 247100000X
Legal business name
STAT X-RAY OF TEXAS INC
Practice address
4124 Gus Thomasson Road
Mesquite, TX 75150-2226
Phone
(972) 682-0484
Fax
(214) 221-5600
NPI assigned
Sep 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Parampottil Tharian Issac, TECHNPI 1336246636
Title
Owner
Phone
(972) 772-4864

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiologic TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 247100000X Primary
Sonography Radiologic TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 2471S1302X

Addresses

Primary practice location

4124 Gus Thomasson Road
Mesquite, TX 75150-2226

Mailing address

4124 Gus Thomasson Road
Mesquite, TX 75150-2226
Phone (972) 682-0484

Other identifiers 3

IdentifierTypeStateIssuer
086087601MedicaidTX
459840OtherTXBCBS
630000308OtherTXRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20071204000552 TX Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 2365531910 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mesquite, TX
O20080827000283 TX Part B Supplier - Portable X-Ray Supplier 2365531910 Practice locations: Mesquite, TX

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785283200000",
    "number": "1417052002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4124 GUS THOMASSON ROAD",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751502226",
            "telephone_number": "972-682-0484",
            "fax_number": "214-221-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4124 GUS THOMASSON ROAD",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751502226",
            "telephone_number": "972-682-0484",
            "fax_number": "214-221-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAT X-RAY OF TEXAS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A",
        "authorized_official_last_name": "ISSAC",
        "authorized_official_first_name": "PARAMPOTTIL",
        "authorized_official_middle_name": "THARIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-772-4864",
        "authorized_official_credential": "TECH"
    },
    "taxonomies": [
        {
            "code": "247100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2471S1302X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Sonography",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "086087601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "459840",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "630000308",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.