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General NPI Number Information
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NPI Number | 1346549888
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Entity Type | Organization
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Legal Business Name | DRC DIAGNOSTICS, LLC
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Dates
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Enumeration Date | 03/23/2011
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Last Update Date | 03/23/2011
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Provider Practice Location Address
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Address Line | 8251 BEDFORD EULESS RD SUITE 210
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City | NORTH RICHLAND HILLS
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State | TX
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Zip | 76180-7200
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Country | US
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Telephone | 817-656-7827
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Fax | 817-485-2212
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Provider Business Mailing Address
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Address Line | 8251 BEDFORD-EULESS ROAD SUITE 210
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City | NORTH RICHLAND HILLS
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State | TX
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Zip | 76180-7200
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Country | US
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Telephone | 817-656-7827
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Fax | 817-485-2212
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. DEEPAK V CHAVDA
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Credential | M.D.
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Telephone | 817-656-7827
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | J5282
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License Number State | TX
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