Provider Demographics
NPI:1619922184
Name:E PLUS PET IMAGING XII LP
Entity type:Organization
Organization Name:E PLUS PET IMAGING XII LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT & CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHAOQIANG
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-587-4079
Mailing Address - Street 1:1250 NORTHWEST HWY STE R
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-5842
Mailing Address - Country:US
Mailing Address - Phone:972-279-5172
Mailing Address - Fax:972-279-6948
Practice Address - Street 1:1250 R NORTHWEST HIGHWAY
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-5851
Practice Address - Country:US
Practice Address - Phone:972-279-5172
Practice Address - Fax:972-279-6948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2025-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0462DCOtherBLUE CROSS/BLUE SHIELD
P00262810OtherRRMEDICARE
FTN028Medicare ID - Type Unspecified