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NPI Code Detail

MEDICARE: MADKO DIAGNOSTICS LLC.

MEDICARE: MADKO DIAGNOSTICS LLC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1246RP1900XPhlebotomy Technician

General Provider Information

NPI Number : 1073299012
Entity Type Code : Organization
Provider Name (Legal Business Name) : MADKO DIAGNOSTICS LLC.
Provider Business Mailing Address
First Line : 7101 CHASE OAKS BLVD APT 121
Second Line :
City : PLANO
State : TX
Zip : 75025-5909
Country : US
Telephone Number : 901-335-7181
Fax Number : 972-666-0104
Provider Business Practice Location Address
First Line : 7101 CHASE OAKS BLVD APT 121
Second Line :
City : PLANO
State : TX
Zip : 75025-5909
Country : US
Telephone Number : 901-335-7181
Fax Number : 972-666-0104
Authorized Official
Title or Position : CERTIFIED PHLEBOTOMIST/ OWNER
Name : MRS. AARIES ANDERSON
Credential : NCPT
Telephone Number : 901-335-7181
Provider Enumeration Date : 06/26/2023
Last Update Date : 06/26/2023

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Directions to “MADKO DIAGNOSTICS LLC. ” Practice Location

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