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General NPI Number Information
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NPI Number | 1710639620
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Entity Type | Organization
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Legal Business Name | ONDEK LABXPRESS LLC
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Dates
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Enumeration Date | 01/21/2022
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Last Update Date | 02/21/2022
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Provider Practice Location Address
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Address Line | 324 E AVENUE D
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City | KILLEEN
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State | TX
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Zip | 76541-5241
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Country | US
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Telephone | 254-651-1717
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Fax |
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Provider Business Mailing Address
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Address Line | 451 E CENTRAL TEXAS EXPY # 250-D
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City | HARKER HEIGHTS
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State | TX
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Zip | 76548-1982
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Country | US
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Telephone | 254-651-1717
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Fax |
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | TANYA LEWIS
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Credential | RN
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Telephone | 254-651-1717
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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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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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