MAXUM HEALTH SERVICES CORP (NPI# 1750348926) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750348926 |
| Entity Type | Organization |
| Organization Name | MAXUM HEALTH SERVICES CORP |
| Other Organization Name | INSIGHT DIAGNOSTICS CENTER - FOREST LANE |
| Practice Address |
11617 N Central Expy Ste 132 Dallas TX 75243-3800 |
| Mailing Address |
Po Box 848074 Dallas TX 75284-8074 |
| Practice Telephone | 2143693795 |
| Practice Fax Number | 2146927953 |
| Mailing Telephone | 9492826000 |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2012-08-20 |
| Authorized Official Name | JAMES F. STANLEY (CHIEF FINANCIAL OFFICER; TREASURER) |
| Authorized Official Telephone | 9492826000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 293D00000X | Physiological Laboratory | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 130085706 | 05 | |
| TX | RAILROAD MEDICARE | 470000639 | 01 |
| Other Name | Type Code |
|---|---|
| InSight Diagnostics Center - Forest Lane | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932166105 | Maxum Health Services Corp | Physiological Laboratory | 1199 8th Ave, Fort Worth, TX 76104-4102 | 2006-04-28 |
| 1760655294 | Maxum Health Services Corp | Physiological Laboratory | 11617 N Central Expy, Mobile Unit, Dallas, TX 75243-3800 | 2008-04-04 |
| 1013974286 | Maxum Health Services Corp | Physiological Laboratory | 17950 Preston Rd, Ste 120, Dallas, TX 75252-5793 | 2006-04-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | MAXUM HEALTH SERVICES CORP. | 5775 Wayzata Blvd., Suite 400, St. Louis Park, Minnesota 55416 |
| Indiana Business Entities | MAXUM HEALTH SERVICES CORP. | 5775 Wayzata Blvd, Suite 400, St Louis Park, MN 55416 |
| Street Address |
11617 N CENTRAL EXPY STE 132 |
| City | DALLAS |
| State | TX |
| Zip Code | 75243-3800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235507880 | Snoring & Fatigue Center | Clinic/Center | 11617 N Central Expy, Suite 250, Dallas, TX 75243-3800 | 2015-09-11 |
| 1144606518 | William Dan Breazeale | Physical Therapist | 11617 N Central Expy, Suite 140, Dallas, TX 75243-3800 | 2015-08-07 |
| 1891187043 | Btdi Jv, LLP | Physiological Laboratory | 11617 N Central Expy, Suite 132, Dallas, TX 75243-3800 | 2015-02-25 |
| 1760655294 | Maxum Health Services Corp | Physiological Laboratory | 11617 N Central Expy, Mobile Unit, Dallas, TX 75243-3800 | 2008-04-04 |
| 1861680324 | Nicole Safford | Physical Therapist | 11617 N Central Expy, Dallas, TX 75243-3800 | 2007-10-10 |
| 1588788582 | Insight Health Corp | Physiological Laboratory | 11617 N Central Expy, Ste 132, Dallas, TX 75243-3800 | 2007-03-17 |
| 1740343177 | Michael E Esedebe Mdpa | Clinic/Center | 11617 N Central Expy, Suite 240, Dallas, TX 75243-3800 | 2006-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558970830 | Nnamdi Okorie | Licensed Vocational Nurse | [email protected], 13427 Hedgeapple Dr, Dallas, TX 75243 | 2020-07-23 |
| 1629627716 | Mohammad Mehdi Imani Emadi | Dentist | 11970 N Central Expy # 430, Dallas, TX 75243 | 2019-09-10 |
| 1295221786 | Cornerstonemd,pllc | Obstetrics & Gynecology | 12222 N Central Expy Ste 140, Dallas, TX 75243 | 2018-07-08 |
| 1033609292 | Mother Earth Healthcare Services Inc | Home Health | 9821 Summerwood Cir Apt 1701, Dallas, TX 75243 | 2018-05-14 |
| 1346742822 | Chioma Ifeji | Licensed Vocational Nurse | 13317 Daystrom Court, Dallas, TX 75243 | 2018-03-01 |
| 1598282865 | Kimberly Ann Whitney | Social Worker | 11520 N Central Expy Ste 254, Dallas, TX 75243 | 2017-08-27 |
| 1962934083 | Dignity Private Care, LLC | In Home Supportive Care | 8330 Lbj Freeway, Ste 720, Dallas, TX 75243 | 2017-03-29 |
| 1699214569 | Vitalis Home Health LLC | Home Health | 9821 Summerwood Cir Apt 1308, Dallas, TX 75243 | 2017-02-13 |
| 1881130946 | Proniles | Non-emergency Medical Transport (VAN) | 12611 Hornbeam Dr, Dallas, TX 75243 | 2017-01-13 |
| 1194273664 | Osman W Awdallah | Non-emergency Medical Transport (VAN) | 12611 Hornbeam Drive, Dallas, TX 75243 | 2016-09-14 |
| Find all providers in zip 75243 | ||||
| Taxonomy Code | 293D00000X |
| Grouping | Laboratories |
| Classification | Physiological Laboratory |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831798875 | Btdi Jv, LLP | Physiological Laboratory | 712 N Washington Ave Ste 102, Dallas, TX 75246-2604 | 2020-10-21 |
| 1033746540 | Enovatemed Solutions, LLC | Physiological Laboratory | 18006 Hillcrest Rd, Dallas, TX 75252-5862 | 2020-03-25 |
| 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 |
| 1144340258 | Digitrace Care Services Inc | Physiological Laboratory | 8700 N Stemmons Fwy, Suite 135, Dallas, TX 75247-3729 | 2007-03-30 |
| Find all providers in DALLAS | ||||
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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.