Provider Demographics
NPI:1043648215
Name:CROSS TIMBERS IMAGING
Entity type:Organization
Organization Name:CROSS TIMBERS IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:HATTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-968-8600
Mailing Address - Street 1:PO BOX 1358
Mailing Address - Street 2:
Mailing Address - City:STEPHENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76401
Mailing Address - Country:US
Mailing Address - Phone:254-965-2663
Mailing Address - Fax:254-968-7979
Practice Address - Street 1:561 N GRAHAM ST STE 102
Practice Address - Street 2:
Practice Address - City:STEPHENVILLE
Practice Address - State:TX
Practice Address - Zip Code:76401-3548
Practice Address - Country:US
Practice Address - Phone:254-968-8600
Practice Address - Fax:254-968-7979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-24
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
No261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00434TMedicare PIN
1243790001Medicare NSC