Living Well Diagnostics Imaging, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

LIVING WELL DIAGNOSTICS IMAGING, LLC

Doing business as

Living Well Medical Services

Practice address

5048 Tennyson Pkwy Ste 250
Plano, TX 75024-3067

Phone

(469) 575-3011

NPI assigned

May 11, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Robert Allen Esty

Title

Chief Operating Officer

Phone

(469) 575-3011

Specialties & licenses 4

Addresses

Other names 1

• Living Well Medical Services Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1336694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564012800000",
    "number": "1548529449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5048 TENNYSON PKWY STE 250",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243067",
            "telephone_number": "469-575-3011",
            "fax_number": "469-575-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5048 TENNYSON PKWY STE 250",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750243067",
            "telephone_number": "469-575-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WELL DIAGNOSTICS IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-11",
        "last_updated": "2019-07-25",
        "status": "A",
        "authorized_official_last_name": "ESTY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "469-575-3011",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bob@thoughtswift.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5048 Tennyson Pkwy Ste 250",
            "city": "Plano",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750243067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Living Well Medical Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Living Well Medical Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Multi-Specialty Clinic/Center in Plano, TX
• Providers in Plano, TX by specialty
• Multi-Specialty Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; 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.