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General NPI Number Information
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NPI Number | 1699172866
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Entity Type | Organization
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Legal Business Name | LANDMARK DIAGNOSTICS, LLC
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Dates
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Enumeration Date | 12/03/2014
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Last Update Date | 03/19/2019
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Provider Practice Location Address
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Address Line | 9350 KIRBY DR SUITE 150
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City | HOUSTON
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State | TX
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Zip | 77054-2527
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Country | US
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Telephone | 888-549-8670
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Fax |
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Provider Business Mailing Address
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Address Line | 5204 W VILLAGE PKWY STE 11
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City | ROGERS
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State | AR
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Zip | 72758-8146
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Country | US
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Telephone | 888-845-6386
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TAYLOR STEWART
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Credential |
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Telephone | 479-845-6386
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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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