Galaxy MRI and Diagnostic Center

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

Legal business name

GALAXY MRI AND DIAGNOSTIC CENTER

Practice address

1110 N Galloway Ave
Mesquite, TX 75149-2436

Phone

(972) 331-4481

Fax

(972) 331-4486

NPI assigned

Dec 19, 2006

Last updated

Jun 15, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John Teig Port, M.D.

Title

Medical Director

Phone

(972) 331-4481

Specialties & licenses 10

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308096000000",
    "number": "1528121340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 N GALLOWAY AVE",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751492436",
            "telephone_number": "972-331-4481",
            "fax_number": "972-331-4486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 N GALLOWAY AVE",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751492436",
            "telephone_number": "972-331-4481",
            "fax_number": "972-331-4486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALAXY MRI AND DIAGNOSTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2011-06-15",
        "status": "A",
        "authorized_official_last_name": "PORT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "TEIG",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "972-331-4481",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "246XS1301X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist Cardiovascular, Sonography",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2471C3401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Computed Tomography",
            "state": "TX",
            "license": "R29608",
            "primary": false
        },
        {
            "code": "2471C3402X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Radiography",
            "state": "TX",
            "license": "R29608",
            "primary": false
        },
        {
            "code": "2471M1202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Magnetic Resonance Imaging",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "2471S1302X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Sonography",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2471V0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Vascular Sonography",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Magnetic Resonance Imaging (MRI)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TX",
            "license": "45D1103817",
            "primary": false
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179171701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "45D1103817",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samuel-Alejandro De Jesus Fuentes, MA, LPC
• Teshia Fuller, REGISTERED NURSE
• Functional Movement Chiropractic
• Jana Fuxa, OT
• G & R Community Healthcare Services
• Sharonda Gales, RN
• Samuel Gallardo, DPT
• Galloway Anesthesia Services,P.a.
• Galloway Clinic PLLC
• Galloway Dental PLLC

• Radiology Clinic/Center in Mesquite, TX
• Providers in Mesquite, TX by specialty
• Radiology Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2011; 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.