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General NPI Number Information
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NPI Number | 1598210353
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Entity Type | Organization
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Legal Business Name | INHEALTH DIAGNOSTIC, LLC
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Dates
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Enumeration Date | 08/22/2016
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Last Update Date | 07/23/2019
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Provider Practice Location Address
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Address Line | 17742 PRESTON RD SUITE #210
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City | DALLAS
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State | TX
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Zip | 75252-6199
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Country | US
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Telephone | 972-674-1913
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Fax | 903-224-8322
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Provider Business Mailing Address
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Address Line | 17742 PRESTON RD SUITE #210
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City | DALLAS
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State | TX
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Zip | 75252-6199
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Country | US
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Telephone | 972-674-1913
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Fax | 903-224-8322
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Authorized Official
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Title or Position | MANAGER
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Name | MR. ALEXI BETHEL
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Credential |
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Telephone | 972-674-1913
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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 | 45D2117218
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License Number State | TX
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