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General NPI Number Information
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NPI Number | 1497054282
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Entity Type | Organization
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Legal Business Name | URBAN DIAGNOSTIC SERVICES, INC.
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Dates
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Enumeration Date | 03/21/2011
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Last Update Date | 03/21/2011
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Provider Practice Location Address
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Address Line | 614 MATLOCK CENTRE CIR
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City | ARLINGTON
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State | TX
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Zip | 76015-2536
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Country | US
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Telephone | 817-800-5630
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Fax | 817-447-9958
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Provider Business Mailing Address
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Address Line | 2716 COUNTY ROAD 804A
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City | BURLESON
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State | TX
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Zip | 76028-1950
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Country | US
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Telephone | 817-800-5630
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Fax | 817-447-9958
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JASON P MOSES
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Credential | DPT, LPT
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Telephone | 817-800-5630
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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 | TX
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