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General NPI Number Information
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NPI Number | 1437705035
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Entity Type | Organization
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Legal Business Name | CLEAR DIAGNOSTICS, LLC
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Dates
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Enumeration Date | 08/11/2019
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Last Update Date | 08/12/2019
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Provider Practice Location Address
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Address Line | 7000 PRESTON RD STE 1500
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City | PLANO
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State | TX
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Zip | 75024-2512
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Country | US
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Telephone | 773-425-4468
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Fax |
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Provider Business Mailing Address
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Address Line | 11625 CUSTER RD STE 110-357
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City | FRISCO
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State | TX
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Zip | 75035-8783
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | OMID GHALAMBOR
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Credential | MD
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Telephone | 773-425-4468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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