INDEPENDENT MOBIL DIAGNOSTICE TESTING FACILITY (NPI# 1437434206) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437434206 |
| Entity Type | Organization |
| Organization Name | INDEPENDENT MOBIL DIAGNOSTICE TESTING FACILITY |
| Practice Address |
1661 Woodard Ave Suite 110 Cleburne TX 76033-7052 |
| Practice Telephone | 8174946875 |
| Mailing Telephone | 8174946875 |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2011-10-12 |
| Authorized Official Name | MR. EDMOND S MAXON (ED) |
| Authorized Official Telephone | 8174946875 |
| Authorized Official Credential | LBSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 22799 | TX | Residential Treatment Facilities |
| Y | 305R00000X | Preferred Provider Organization | 22799 | TX | Managed Care Organizations |
| Street Address |
1661 WOODARD AVE SUITE 110 |
| City | CLEBURNE |
| State | TX |
| Zip Code | 76033-7052 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629628631 | Barbara Hicks | Technician | 1020 Highland Rd, Cleburne, TX 76033 | 2019-09-12 |
| 1346758315 | Tabatha Estes | Physician Assistant | 2010 W Katherine P Raines Rd Ste 100, Cleburne, TX 76033 | 2018-01-11 |
| 1053836759 | A Bright Foundation | Community/Behavioral Health | 509 Graham Street, Cleburne, TX 76033 | 2017-08-03 |
| 1891162491 | Lesa Hough | Occupational Therapist | 1503 Twin Oaks Ct, Cleburne, TX 76033 | 2015-08-31 |
| 1043695984 | Eduy J James | Nurse Practitioner | 128 S. Ridgeway Drive, Cleburne, TX 76033 | 2015-07-21 |
| 1306235775 | Bavousett's Caring Keepers | Registered Nurse | 405 N. Ridgeway Dr., Suite 1-a, Cleburne, TX 76033 | 2015-01-22 |
| 1679994313 | Health Imaging Partners LLC | Physiological Laboratory | 203 Walls Drive, Ste 101, Cleburne, TX 76033 | 2013-12-24 |
| 1043641079 | Melinda Weber | Counselor | 1819 Cr #1107a, Cleburne, TX 76033 | 2013-12-02 |
| 1356778070 | Jeremy Lamar Carter | Psychologist | 904 E Henderson St, Cleburne, TX 76033 | 2013-09-27 |
| 1770844102 | Heart To Heart Hospice of The Brazos, LLC | Hospice Care, Community Based | 1200 W Henderson St Ste I, Cleburne, TX 76033 | 2012-06-01 |
| Find all providers in zip 76033 | ||||
| Taxonomy Code | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
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| 1154983492 | Cassandra Denese Mitchell | Preferred Provider Organization | 8319 Heights Vly, Converse, TX 78109-3503 | 2019-07-08 |
| 1083187223 | Chinese Community Center, Inc. | Preferred Provider Organization | 9800 Town Park Dr, Houston, TX 77036-2316 | 2019-01-10 |
| 1013422492 | Cicero L Sadler | Preferred Provider Organization | 4001 San Jacinto St, Houston, TX 77004-4021 | 2017-12-07 |
| 1528577483 | Mary Brown-jacobs | Preferred Provider Organization | 501 Canvas Ct, Crowley, TX 76036-4338 | 2017-09-22 |
| 1962931220 | Ai Community Services LLC | Preferred Provider Organization | 6928 Shoreway Dr, Grand Prairie, TX 75054 | 2017-06-08 |
| 1649706227 | Divine Integrity Allied Healthcare Services | Preferred Provider Organization | 4738 Bedford Ave, Midland, TX 79703-4535 | 2017-05-03 |
| 1255866950 | Guardian of Angels Community Living | Preferred Provider Organization | 12703 Jones Rd, 1115, Houston, TX 77070-4676 | 2017-05-01 |
| 1356874622 | Urban Line LLC | Preferred Provider Organization | 2500 Woodland Park Dr Apt C304, Houston, TX 77077-2278 | 2017-04-04 |
| Find all providers with the same taxonomy | ||||
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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.