Healthcare Provider Details

I. General information

NPI: 1205355849
Provider Name (Legal Business Name): ATTIMAX LABORATORY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2017
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4521 S STAPLES ST STE 100
CORPUS CHRISTI TX
78411-2603
US

IV. Provider business mailing address

4521 S STAPLES ST STE 100
CORPUS CHRISTI TX
78411-2603
US

V. Phone/Fax

Practice location:
  • Phone: 361-724-3892
  • Fax: 361-730-1052
Mailing address:
  • Phone: 361-724-3892
  • Fax: 361-730-1052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY CARUSO
Title or Position: OWNER
Credential:
Phone: 361-724-3892