DYNAMIC X-RAY INC. (NPI# 1811399678) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811399678 |
| Entity Type | Organization |
| Organization Name | DYNAMIC X-RAY INC. |
| Practice Address |
4230 Lbj Fwy Ste, 111 Dallas TX 75244-5806 |
| Mailing Address |
291 Stone Mountain Dr Sunnyvale TX 75182-2655 |
| Practice Telephone | 9723527260 |
| Mailing Telephone | 9723527260 |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2018-06-20 |
| Authorized Official Name | MR. BENNY J. ILLICKAL (OWNER) |
| Authorized Official Telephone | 9723527260 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 246XS1301X |
Spec/Tech, Cardiovascular Specialization: Sonography |
TX | Technologists, Technicians & Other Technical Service Providers | |
| N | 2471C3402X |
Radiologic Technologist Specialization: Radiography |
TX | Technologists, Technicians & Other Technical Service Providers | |
| N | 2471V0105X |
Radiologic Technologist Specialization: Vascular Sonography |
TX | Technologists, Technicians & Other Technical Service Providers | |
| N | 2471S1302X |
Radiologic Technologist Specialization: Sonography |
TX | Technologists, Technicians & Other Technical Service Providers | |
| Y | 247100000X | Radiologic Technologist | TX | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
4230 LBJ FWY STE, 111 |
| City | DALLAS |
| State | TX |
| Zip Code | 75244-5806 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972548725 | Amrita Group Inc | Home Health | 4230 Lbj Fwy, Suite 128, Dallas, TX 75244-5806 | 2006-06-17 |
| 1114380854 | Comfort One Palliative and Hospice Care, LLC | Hospice Care, Community Based | 4230 Lbj Fwy, Suite 200g, Dallas, TX 75244-5806 | 2016-03-31 |
| 1326483298 | Apollo Hospice Inc | Hospice Care, Community Based | 4230 Lbj Fwy, Suite 153, Dallas, TX 75244 | 2013-05-06 |
| 1679844120 | Resk Healthcare Inc | Hospice Care, Community Based | 4230 Lbj Fwy, Suite 153, Dallas, TX 75244 | 2012-01-14 |
| 1134356918 | Dallas Radiology,p.a. | Radiology | 4230 Lbj Fwy, Suite 520, Dallas, TX 75244-5806 | 2009-06-18 |
| 1043464324 | Platinum Plus Home Health Inc | Home Health | 4230 Lbj Fwy, Suite 129, Dallas, TX 75244-5806 | 2008-11-12 |
| 1821246182 | Hemorrhoid Care Clinic of Texas | Family Medicine | 4230 Lbj Fwy, Suite 308, Dallas, TX 75244-5806 | 2008-08-28 |
| 1952339392 | Albert George Tesoriero | Radiology | 4230 Lbj Fwy, Suite 520, Dallas, TX 75244-5806 | 2006-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316561194 | Kevin Goodnight | Behavioral Analyst | 4230 Sigma Road, Dallas, TX 75244 | 2020-06-08 |
| 1851941413 | Medi-wheels, LLC | Durable Medical Equipment & Medical Supplies | 5005 Lbj Freeway, Ste. 840, Dallas, TX 75244 | 2019-09-16 |
| 1972157436 | Samantha Lograsso | Nurse Practitioner | 4055 Valley View Ln Suite 400, Dallas, TX 75244 | 2019-08-01 |
| 1205313780 | Cherae Ashland Burton | Licensed Vocational Nurse | 4099 Mcewen Rd., Farmers Branch, TX 75244 | 2018-07-26 |
| 1700383197 | Melissa Fitts | Behavioral Analyst | 13604 Midway Rd. #180, Farmers Branch, TX 75244 | 2018-04-11 |
| 1932607983 | Vcphcs, Lp | Clinic/Center | 5001 Spring Valley Road, Suite 600 East, Dallas, TX 75244 | 2018-01-24 |
| 1518406636 | Gentech Laboratories LLC | Clinical Medical Laboratory | 4403 N. Beltwood Parkway, Suite 300, Dallas, TX 75244 | 2017-02-22 |
| 1881045680 | Innovative Lifeskills Training Center LLC | Preferred Provider Organization | 5001 Spring Valley, Towers East Ste 400, Dallas, TX 75244 | 2016-06-23 |
| 1376992792 | Lynnlie Tuschoff | Registered Nurse | 4099 Mcewen, Suite 250, Farmers Brach, TX 75244 | 2016-06-07 |
| 1609223072 | Debra Jules | Licensed Vocational Nurse | 4099 Mcewen Road, Dallas, TX 75244 | 2016-05-16 |
| Find all providers in zip 75244 | ||||
| Taxonomy Code | 247100000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467087049 | Alaa Mohamed | Radiologic Technologist | 8330 Lyndon B Johnson Fwy Ste B302, Dallas, TX 75243-1166 | 2020-03-04 |
| 1700339959 | Nina Tokpawhiea | Radiologic Technologist | 9900 Adleta Blvd Apt 711, Dallas, TX 75243-9211 | 2016-07-24 |
| 1508101718 | Cross Diagnostic Imaging Inc | Radiologic Technologist | 2701 S Hampton Rd Ste 140, Dallas, TX 75224-2363 | 2012-11-29 |
| 1427002682 | Osteoporosis Screening Services Inc | Radiologic Technologist | 2301 S Hampton Rd Ste 700, Dallas, TX 75224-1678 | 2006-05-20 |
| 1669470241 | The Medical Shop, Inc | Radiologic Technologist | 3840 W Northwest Hwy, Suite 400, Dallas, TX 75220-5162 | 2005-07-08 |
| 1396291548 | Marveline Pacheco | Radiologic Technologist | 9441 Lbj Frwy, #602, Dallas, TX 75243 | 2016-08-28 |
| 1407226129 | Clifton Wright | Radiologic Technologist | 2201 Main St, Ste1299, Dallas, TX 75201-4327 | 2015-10-07 |
| 1891122503 | Universal Imaging Services LLC | Radiologic Technologist | 13154 Coit Rd, #202, Dallas, TX 75240-5773 | 2013-09-26 |
| 1790719722 | Carrie Lynn Robson | Radiologic Technologist | 9850 N Central Expy, #268, Dallas, TX 75231-4325 | 2006-07-10 |
| 1114971637 | Quality Portable X-ray, LLC | Radiologic Technologist | 9850 N Central Expy, #268, Dallas, TX 75231-4325 | 2006-05-20 |
| 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.