ADELAIDE DIAGNOSTIC CENTER LLC (NPI# 1205933256) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205933256 |
| Entity Type | Organization |
| Organization Name | ADELAIDE DIAGNOSTIC CENTER LLC |
| Practice Address |
2692 W Walnut St Suite #108 Garland TX 75042-6474 |
| Mailing Address |
1123 Westminister Ave Murphy TX 75094-4158 |
| Practice Telephone | 2143283333 |
| Practice Fax Number | 2143283330 |
| Mailing Telephone | 2143283333 |
| Mailing Fax Number | 2143283330 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2008-02-19 |
| Authorized Official Name | MR. JACKSON JACOB (GENERAL MANAGER) |
| Authorized Official Telephone | 2143283333 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 293D00000X | Physiological Laboratory | Laboratories | ||
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
J6228 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BC/BS | 0623DC | 01 |
| Street Address |
2692 W WALNUT ST SUITE #108 |
| City | GARLAND |
| State | TX |
| Zip Code | 75042-6474 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619969003 | Robert Wayne Bradley | Specialist | 2692 W Walnut St, Suite 105, Garland, TX 75042-6474 | 2005-08-22 |
| 1316389737 | Rcr Healthcare Dallas LLC | Psychiatric Hospital | 2692 W Walnut St, Garland, TX 75042-6474 | 2013-07-26 |
| 1609962661 | Cristy M Schade Md Pa | Specialist | 2692 W Walnut St, Suite 105, Garland, TX 75042-6474 | 2006-10-05 |
| 1447263215 | Jeffrey H Pinotti | Chiropractor | 2692 W Walnut St, Suite 105, Garland, TX 75042-6474 | 2006-08-14 |
| 1477560209 | Mcdonald Hugo Walker | Emergency Medicine | 2692 W Walnut St, Garland, TX 75042-6474 | 2006-08-02 |
| 1396759825 | Ramon Quinones | Surgery | 2692 W Walnut St, Ste 209, Garland, TX 75042-6474 | 2006-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699259697 | Abiodun Gloria Irabor-musa | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3106 Centennial Dr, Garland, TX 75042 | 2018-09-17 |
| 1356870620 | Brad Taylor Landrum | Family Medicine | 601 Clara Barton Blvd., Suite 340, Garland, TX 75042 | 2017-06-08 |
| 1043662034 | Alicia Valdiviezo | Physician Assistant | 2046 Forest Ln Ste 130, Garland, TX 75042 | 2016-07-01 |
| 1053711184 | Jamette Hickman | Physical Therapist | 705 Walter Reed Blvd Suite 100, Garland, TX 75042 | 2014-08-26 |
| 1619397932 | Saint Catherine Hospice Inc. | Hospice, Inpatient | 4229 Glenhaven Drive, Garland, TX 75042 | 2014-04-25 |
| 1821424094 | Angel Care Team | Adult Companion | 1801 Evelyn Dr., Garland, TX 75042 | 2013-09-19 |
| 1427311042 | Baylor Family Medicine Clinic | Case Manager/Care Coordinator | 601 Clara Barton, 340, Garland, TX 75042 | 2012-06-19 |
| 1003176959 | Benedict Eric Homer | Dentist | 813 North Jupiter Rd., Garland, TX 75042 | 2012-05-25 |
| 1518254929 | Rama Sulochana Narla | Emergency Medicine | 601, Clara Barton Blvd, Ste 340, Garland, TX 75042 | 2011-07-06 |
| 1093002917 | Mecca Group | Community/Behavioral Health | 1213 Patricia Ln, Garland, TX 75042 | 2011-06-29 |
| Find all providers in zip 75042 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295926483 | Ronald Dayton Sullivan | Radiology | 2300 Marie Curie Blvd., Baylor Medical Center At Garland, Garland, TX 75042 | 2007-08-05 |
| 1083662654 | Michael Scott Allen | Radiology | 3114 Bluffview Dr, Garland, TX 75043-1454 | 2006-05-05 |
| 1255303269 | Scott A Garoutte | Radiology | 2300 Marie Curie Dr, Garland, TX 75042-5706 | 2006-02-03 |
| 1386616753 | Sheri Lynn Hockett | Radiology | 2300 Marie Curie Blvd, Garland, TX 75042 | 2006-02-01 |
| 1619512993 | Exceptional Garland Medical Plaza Imaging LLC | Radiology | 4555 W Walnut St, Garland, TX 75042-5143 | 2019-11-11 |
| 1467893099 | Rose Imaging Specialists Pa | Radiology | 4430 Lavon Dr, Garland, TX 75040-3000 | 2013-07-11 |
| 1457324527 | Soume Daulat Foshee | Radiology | 2300 Marie Curie Blvd, Garland, TX 75042 | 2006-02-09 |
| 1447222450 | Robert E Flynn | Radiology | 2300 Marie Curie Blvd, Garland, TX 75042 | 2006-02-03 |
| 1104898113 | Imaging Consultants of Garland LLP | Radiology | 2300 Marie Curie Blvd, Garland, TX 75042 | 2006-02-03 |
| 1063484079 | Michael J Trombello | Radiology | 2300 Marie Curie Dr, Garland, TX 75042-5706 | 2006-02-03 |
| Find all providers in GARLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.