Provider Demographics
NPI:1730383936
Name:CRITERION IMAGING
Entity type:Organization
Organization Name:CRITERION IMAGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHARA
Authorized Official - Middle Name:R
Authorized Official - Last Name:BAROUSSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-759-5140
Mailing Address - Street 1:7515 GREENVILLE AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-3831
Mailing Address - Country:US
Mailing Address - Phone:972-759-5140
Mailing Address - Fax:
Practice Address - Street 1:7515 GREENVILLE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-3831
Practice Address - Country:US
Practice Address - Phone:972-759-5140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology