Prestige Diagnostics, LLC

Primary specialty

Radiology Clinic/CenterTaxonomy code 261QR0200X

License

P00343899 Issued in TX

Legal business name

PRESTIGE DIAGNOSTICS, LLC

Practice address

6491 Southwest Blvd
Benbrook, TX 76132-2777

Phone

(817) 887-9750

Fax

(817) 887-9753

NPI assigned

Jun 13, 2014

Organization subpart

No

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

Authorized official

Name

Katherine Michelle Taylor

Title

Owner/Manger

Phone

(817) 887-9750

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1402617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402617600000",
    "number": "1861806283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6491 SOUTHWEST BLVD",
            "city": "BENBROOK",
            "state": "TX",
            "postal_code": "761322777",
            "telephone_number": "817-887-9750",
            "fax_number": "817-887-9753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6491 SOUTHWEST BLVD",
            "city": "BENBROOK",
            "state": "TX",
            "postal_code": "761322777",
            "telephone_number": "817-887-9750",
            "fax_number": "817-887-9753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE DIAGNOSTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-13",
        "last_updated": "2014-06-13",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER/MANGER",
        "authorized_official_telephone_number": "817-887-9750"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "TX",
            "license": "P00343899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Joseph Pitre Sr., LMSW-ACP
• Chalee Pittman
• Dana Rachelle Pitts, LPC
• Aislinn Pool
• Jeremy Lee Pope, DDS
• Prestige Imaging, LLC
• Prime Diagnostic Imaging of Fort Worth, LLC
• Olivia May Pringle
• Haley Quackenbush
• R. Danford Doss, DDS, Inc

• Radiology Clinic/Center in Benbrook, TX
• Providers in Benbrook, 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 13, 2014; 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.