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General NPI Number Information
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NPI Number | 1104216605
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Entity Type | Organization
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Legal Business Name | PHR DIAGNOSTICS, LLC
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Dates
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Enumeration Date | 02/04/2015
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Last Update Date | 12/22/2020
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Provider Practice Location Address
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Address Line | 13601 PRESTON RD STE 1050E
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City | DALLAS
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State | TX
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Zip | 75240-4927
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Country | US
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Telephone | 469-913-7042
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Fax | 516-534-2074
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Provider Business Mailing Address
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Address Line | 34 SANDY BROOK DR
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City | SPRING VALLEY
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State | NY
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Zip | 10977-1214
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Country | US
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Telephone | 347-210-6969
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Fax | 214-396-9441
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Authorized Official
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Title or Position | OWNER
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Name | MR. DAVID SOBEL
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Credential |
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Telephone | 347-210-6969
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State | TX
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