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NPI Code Detail

MEDICARE: KEMPO LAB LLC

MEDICARE: KEMPO LAB LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1291U00000XClinical Medical Laboratory

General Provider Information

NPI Number : 1144928862
Entity Type Code : Organization
Provider Name (Legal Business Name) : KEMPO LAB LLC
Provider Business Mailing Address
First Line : 13601 PRESTON RD STE 425W
Second Line :
City : DALLAS
State : TX
Zip : 75240-4985
Country : US
Telephone Number : 214-758-0104
Fax Number : 214-758-0049
Provider Business Practice Location Address
First Line : 13601 PRESTON RD STE 425W
Second Line :
City : DALLAS
State : TX
Zip : 75240-4985
Country : US
Telephone Number : 214-758-0104
Fax Number : 214-758-0049
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : MR. MEHMET E ILIK
Credential :
Telephone Number : 214-758-0104
Provider Enumeration Date : 02/21/2023
Last Update Date : 02/21/2023

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Directions to “KEMPO LAB LLC ” Practice Location

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