OrganizationActive
Boulevard Diagnostic Mgmt Group
NPI 1922343342 · Radiology Clinic/Center · Southlake, TX
Provider details
- NPI number
- 1922343342
- Entity type
- Organization
- Primary specialty
- Radiology Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- James Waller, Operations Manager(817) 741-0808
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(78/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3120 W Southlake Blvd # 140
Southlake, TX 76092-6783
Phone: (817) 741-0808
Fax: (817) 741-0841
Street-level locationGet directions
Mailing address
3120 W Southlake Blvd # 140
Southlake, TX 76092-6783
Registry dates
- Enumerated
- 2012-12-11
- Last updated
- 2012-12-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.