Healthcare Provider Details

I. General information

NPI: 1659184521
Provider Name (Legal Business Name): TEXAS PCR TESTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1464 E WHITESTONE BLVD STE 202
CEDAR PARK TX
78613-9062
US

IV. Provider business mailing address

1464 E WHITESTONE BLVD STE 202
CEDAR PARK TX
78613-9062
US

V. Phone/Fax

Practice location:
  • Phone: 773-569-4631
  • Fax:
Mailing address:
  • Phone: 773-569-4631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: SYED IBRAHIM ALI
Title or Position: OWNER
Credential:
Phone: 773-569-4631