BREAST DIAGNOSTICS, PA
Medical Practice at Broad Park Cir, Midlothian, TX

License number
Texas M00778
Category
Medical Practice
Type
Specialist
Owner
Name: PRIYA R VENUGOPAL MD
Title: PRESIDENT
Phone: (817) 749-2000
Address
Address 2
1750 Broad Park Cir S SUITE 300, Midlothian, TX 76063
1545 E Southlake Blvd SUITE 200, Grapevine, TX 76092
National Provider ID: 1871820423
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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BREAST DIAGNOSTICS, PA

800 Elmbrook Ct, Southlake, TX 76092

Industry:
Medical Doctor's Office
Doing business as:
Breast Diagnostics, PA
Registration:
Oct 14, 2004
State ID:
0800402330
Business type:
Professional Association
President, Treasurer, Secretary, Director, Member:
Priya R. Venugopal (President, Treasurer, Secretary, Director, Member)
TIN:
32035523060

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