NPIMap

Organization Active NPI

Elite View Imaging, LLC

  • Radiology Clinic/Center
  • Mansfield, TX
National Provider Identifier
1497198147
Registry record updated Apr 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
R33761-000 Issued in TX
Legal business name
ELITE VIEW IMAGING, LLC
Practice address
1750 Broad Park Cir S
Suite 300
Mansfield, TX 76063-7832
Phone
(682) 200-2517
Fax
(682) 200-2518
NPI assigned
Apr 12, 2013
Organization subpart
Yes
Parent organization
ELITE VIEW IMAGING, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 12, 2013

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

Authorized official

Name
James A Waller
Title
Manager
Phone
(817) 528-7044

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X R33761-000 TX Primary

Addresses

Primary practice location

1750 Broad Park Cir S
Suite 300
Mansfield, TX 76063-7832

Mailing address

3120 W Southlake Blvd
Suite 140
Southlake, TX 76092-6783
Phone (817) 741-0808

Other names 1

  • Broad Park Imaging, LLC Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Elite View Imaging LLC6 organizations share this tax ID, including this one
Part of
Elite View Imaging LLC

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3120 W Southlake Blvd
Ste 140
Southlake, TX 76092
Phone (817) 741-0808

NPI Registry JSON

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

{
    "created_epoch": "1365724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365724800000",
    "number": "1497198147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 W SOUTHLAKE BLVD",
            "address_2": "SUITE 140",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926783",
            "telephone_number": "817-741-0808",
            "fax_number": "817-741-0841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 BROAD PARK CIR S",
            "address_2": "SUITE 300",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760637832",
            "telephone_number": "682-200-2517",
            "fax_number": "682-200-2518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE VIEW IMAGING, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ELITE VIEW IMAGING, LLC",
        "enumeration_date": "2013-04-12",
        "last_updated": "2013-04-12",
        "status": "A",
        "authorized_official_last_name": "WALLER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "817-528-7044"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "TX",
            "license": "R33761-000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broad Park Imaging, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.