Maxum Health Services Corp

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

MAXUM HEALTH SERVICES CORP

Practice address

1199 8TH Ave
Fort Worth, TX 76104-4102

Phone

(817) 335-9729

Fax

(817) 877-3868

NPI assigned

Apr 28, 2006

Organization subpart

No

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

Authorized official

Name

James F. Stanley

Title

Chief Financial Officer; Treasurer

Phone

(949) 282-6000

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• InSight Diagnostic Center - Eighth Ave Doing business as

Locations

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345420800000",
    "number": "1932166105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 848074",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752848074",
            "telephone_number": "949-282-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1199 8TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044102",
            "telephone_number": "817-335-9729",
            "fax_number": "817-877-3868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXUM HEALTH SERVICES CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-28",
        "last_updated": "2012-08-20",
        "status": "A",
        "authorized_official_last_name": "STANLEY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER; TREASURER",
        "authorized_official_telephone_number": "949-282-6000"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "470001131",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155916301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "InSight Diagnostic Center - Eighth Ave",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gabrielle Mavelian, DO
• Gaurav Gajanan Mavinkurve, M.D.
• Max Dental Care PA
• Maxim Healthcare Services, Inc.
• Jason Maxtin, LCSW
• Maxum Health Services Corp.
• Maxus Healthcare Partners LLC
• Maxus Healthcare Partners LLC
• Maxwell Coats Surgical Assisting, LLC
• Maxwell Surgery Assistants, LLC

• Physiological Laboratory in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Physiological Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2012; 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.