INNERFACE IMAGING LLC


Address: 10100 N Central Expressway, Ste 100, Dallas, TX 75231
Phone: 2143469129

INNERFACE IMAGING LLC (NPI# 1972512994) 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) 1972512994
Entity Type Organization
Organization Name INNERFACE IMAGING LLC
Practice Address 10100 N Central Expressway
Ste 100
Dallas
TX 75231
Mailing Address 4630 Eubank Blvd Ne
Albuquerque
NM 87111
Practice Telephone 2143469129
Practice Fax Number 2143461983
Mailing Telephone 5053239906
Mailing Fax Number 5052987227
Enumeration Date 2006-08-07
Last Update Date 2020-08-22
Authorized Official Name E GARY FICHTNER (OWNER)
Authorized Official Telephone 5053141669
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 293D00000X Physiological Laboratory Laboratories

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1063421089 Innerface Imaging LLC Physiological Laboratory 8400 Osuna Blvd Ne, Suite 5c, Albuquerque, NM 87111 2006-08-07

Office Location

Street Address 10100 N CENTRAL EXPRESSWAY
STE 100
City DALLAS
State TX
Zip Code 75231

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1760964100 Amber Nicole Caruthers Nurse Practitioner 8060 Park Lane, Dallas, TX 75231 2018-09-01
1376024893 Brittany Leigh Stedman Physical Therapist 8130 Meadow Rd, Dallas, TX 75231 2018-08-23
1700367224 Tia Cornelius Occupational Therapy Assistant 8130 Meadow Rd., Dallas, TX 75231 2018-08-23
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Taxonomy Information

Taxonomy Code 293D00000X
Grouping Laboratories
Classification Physiological Laboratory

Taxonomy Definition

A laboratory that operates independently of a hospital and physician’s office to furnish physiological diagnostic services (e.g. EEG’s , EKG’s, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services.
Notes: Source: Paraphrased from the Medicare Carrier Manual, Section 2070.5.

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1205475829 Intraoperative Neuro Professionals Physiological Laboratory 25 Highland Park Vlg # 100-470, Dallas, TX 75205-2789 2019-12-30
1881237568 Mbb Management Physiological Laboratory 12700 Hillcrest Rd Ste 158, Dallas, TX 75230-2055 2019-10-24
1730738386 Foj Neuro Diagnostics LLC Physiological Laboratory 13421 Tangleridge Ln, Dallas, TX 75240-5342 2019-09-06
1184283053 Brainwave Diagnostic LLC Physiological Laboratory 7777 Forest Ln Ste B416, Dallas, TX 75230-2566 2019-06-13
1780196576 Progressive Neuro Diagnostics Physiological Laboratory 350 N Saint Paul St Apt 2114, Dallas, TX 75201-4220 2017-11-01
1588981831 Pro-tech-tive Neuromonitoring, LLC Physiological Laboratory 10114 Pinecrest Dr, Dallas, TX 75228-3257 2010-04-27
1144550369 Health Imaging Partners LLC Physiological Laboratory 12201 Merit Dr Ste 100, Dallas, TX 75251-2122 2010-01-11
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City DALLAS
Zip Code 75231

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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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