Healthcare Provider Details

I. General information

NPI: 1639727662
Provider Name (Legal Business Name): DIGITAL DIAGNOSTICS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2019
Last Update Date: 04/16/2021
Certification Date: 04/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 N CAPITAL OF TEXAS HWY STE 450
AUSTIN TX
78746-0034
US

IV. Provider business mailing address

2300 OAKDALE BLVD
CORALVILLE IA
52241-9702
US

V. Phone/Fax

Practice location:
  • Phone: 512-231-0500
  • Fax:
Mailing address:
  • Phone: 319-248-5620
  • Fax: 319-343-1052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: JOHN BERTRAND
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 319-248-5620