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General NPI Number Information
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NPI Number | 1023258894
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL VASCULAR DIAGNOSTICS INC.
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Dates
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Enumeration Date | 03/05/2009
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Last Update Date | 03/05/2009
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Provider Practice Location Address
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Address Line | 8210 WALNUT HILL LN SUITE 907
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City | DALLAS
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State | TX
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Zip | 75231-4405
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Country | US
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Telephone | 214-577-7012
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 740213
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City | DALLAS
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State | TX
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Zip | 75374-0213
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Country | US
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Telephone | 214-577-7012
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Fax | 469-728-0838
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Authorized Official
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Title or Position | SECRETARY
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Name | MR. JON CHRISTOPHER KENDALL
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Credential | RVT
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Telephone | 214-577-7012
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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