Healthcare Provider Details
I. General information
NPI: 1649498213
Provider Name (Legal Business Name): PRECISE DIAGNOSTICS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/21/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3107 FAREWAY LN
MT PLEASANT TX
75455-6731
US
IV. Provider business mailing address
PO BOX 2241
MT PLEASANT TX
75456-2241
US
V. Phone/Fax
- Phone: 903-577-3001
- Fax:
- Phone: 903-577-3001
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 293D00000X |
| Taxonomy | Physiological Laboratory |
| License Number | D2622 |
| License Number State | TX |
VIII. Authorized Official
Name:
MONICA
MATKIN
Title or Position: PRESIDENT
Credential:
Phone: 903-577-3001