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General NPI Number Information
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NPI Number | 1851818785
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Entity Type | Organization
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Legal Business Name | MEDLIFE DIAGNOSTIC SERVICES INC
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Dates
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Enumeration Date | 08/22/2017
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Last Update Date | 10/05/2020
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Provider Practice Location Address
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Address Line | 17774 PRESTON RD
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City | DALLAS
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State | TX
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Zip | 75252-5736
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Country | US
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Telephone | 832-367-8990
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Fax |
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Provider Business Mailing Address
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Address Line | 17774 PRESTON RD
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City | DALLAS
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State | TX
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Zip | 75252-5736
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Country | US
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Telephone | 877-400-9729
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | SYED ALIKHAN
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Credential |
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Telephone | 847-858-6620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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