1649401878 NPI number — OPUS LABORATORY AND DIAGNOSTIC

Table of content: (NPI 1649401878)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649401878 NPI number — OPUS LABORATORY AND DIAGNOSTIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OPUS LABORATORY AND DIAGNOSTIC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DIAGNOSTIC ALLIANCE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649401878
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/29/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7941 KATY FWY
Provider Second Line Business Mailing Address:
277
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77024-1924
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-224-4674
Provider Business Mailing Address Fax Number:
832-201-7055

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7807 LONG POINT RD
Provider Second Line Business Practice Location Address:
430
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77055-3679
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-224-4674
Provider Business Practice Location Address Fax Number:
832-201-7055
Provider Enumeration Date:
08/05/2009

Additional Information

Authorized Official

Authorized Official Last Name:
CALHOUN
Authorized Official First Name:
JANA
Authorized Official Middle Name:
BUSBY
Authorized Official Title or Position:
MANAGING PARTNER
Authorized Official Telephone Number:
713-550-3029

Provider Taxonomy Codes

  • Taxonomy code: 247200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com