ETSUB NEGUSSIE HAILESELASSIE


Address: 1702 Arbor Creek Dr., Garland, TX 75040
Phone: 4692697259

ETSUB NEGUSSIE HAILESELASSIE (NPI# 1801312947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1801312947
Entity Type Individual
Full Name ETSUB NEGUSSIE HAILESELASSIE
Practice Address 1702 Arbor Creek Dr.
Garland
TX 75040
Mailing Address 1702 Arbor Creek Dr
Garland
TX 75040-8912
Practice Telephone 4692697259
Enumeration Date 2017-08-21
Last Update Date 2019-04-30
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2085B0100X Radiology
Specialization: Body Imaging
454534 TX Allopathic & Osteopathic Physicians

Provider Secondary Practice Location

Address Telephone Number Fax Number
10641 Steppington Dr, Dallas, TX 752304676 4692697259

Office Location

Street Address 1702 ARBOR CREEK DR.
City GARLAND
State TX
Zip Code 75040

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Taxonomy Information

Taxonomy Code 2085B0100X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Body Imaging

Taxonomy Definition

A Radiology doctor of Osteopathy that specializes in Body Imaging.
Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: definiton added, source added] Additional Resources: The American Osteopathic Board of Radiology no longer offers a certificate in this specialty.

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1578820866 Kuang-wei Eric Chang Radiology 2112 Sw H K Dodgen Loop Ste 110, Temple, TX 76504-7011 2012-04-12
1043583008 1st South Texas Pain Management Radiology 1431 Wirt Rd., 113, Houston, TX 77055 2012-02-21
1194058800 Carlos Maldonado, D.o., P.a. Radiology 2933 Lazy Lake Dr, Harlingen, TX 78550-8633 2009-09-13
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1518180488 Border Radiology Consultants PC Radiology 1155 N Zaragoza Rd, Suite C107, El Paso, TX 79907-1812 2007-04-10
1861551046 Radiology Associates of North Texas Pa Radiology 2911 Oak Park Cir, Fort Worth, TX 76109-1893 2006-12-06
1851450969 Radiology Associates of North Texas Pa Radiology 525 E Southlake Blvd, Southlake, TX 76092-6235 2006-12-06
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Competitor

Search similar providers

City GARLAND
Zip Code 75040

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Dataset Information

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.

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