Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Boulevard Diagnostic Mgmt Group

Organization Radiology Clinic/Center · NPI 1922343342

Boulevard Diagnostic Mgmt Group is a Radiology Clinic/Center in Southlake, Texas. Registered with an NPI since 2012.

In the registry since
2012

Practice location Address checks out

3120 W Southlake Blvd # 140
Southlake, TX 76092-6783
Phone: (817) 741-0808
Fax: (817) 741-0841
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Radiology Clinic/Center (primary) Taxonomy 261QR0200X

Record details

NPI number1922343342
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official James Waller — Operations Manager · (817) 741-0808
NPI enumeratedDecember 11, 2012
Last updated in NPPESDecember 11, 2012
Mailing address3120 W Southlake Blvd # 140, Southlake, TX 76092-6783

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