Provider Demographics
NPI:1730835125
Name:GCS DIAGNOSTICS LLC
Entity type:Organization
Organization Name:GCS DIAGNOSTICS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:DANIELLE
Authorized Official - Last Name:GARTRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-580-8352
Mailing Address - Street 1:251 E SOUTHLAKE BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6298
Mailing Address - Country:US
Mailing Address - Phone:817-337-3433
Mailing Address - Fax:
Practice Address - Street 1:2401 IRA E WOODS AVE STE 600
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-8631
Practice Address - Country:US
Practice Address - Phone:817-488-9991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-24
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Single Specialty