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General NPI Number Information
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NPI Number | 1700150828
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Entity Type | Organization
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Legal Business Name | TEXAS MEDICAL SPECIALTY, INC.
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Dates
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Enumeration Date | 03/07/2012
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Last Update Date | 03/07/2012
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Provider Practice Location Address
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Address Line | 7777 FOREST LN SUITE C-768
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City | DALLAS
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State | TX
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Zip | 75230-2571
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Country | US
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Telephone | 972-566-5761
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Fax | 972-566-7720
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Provider Business Mailing Address
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Address Line | 7777 FOREST LN SUITE C-768
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City | DALLAS
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State | TX
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Zip | 75230-2571
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Country | US
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Telephone | 972-566-5761
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Fax | 972-566-7720
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Authorized Official
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Title or Position | PRESIDENT/DIRECTOR
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Name | DR. AFZAL NIKAEIN
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Credential | PH.D.; HCLD
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Telephone | 972-566-5761
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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 | 6341
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License Number State | MO
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