MEDICARE: ACCUMOLECULAR DIAGNOSTICS

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
1	291U00000X	Clinical Medical Laboratory		TX

General Provider Information

NPI Number	:	1154455855
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCUMOLECULAR DIAGNOSTICS

Provider Business Mailing Address
First Line	:	2140 BABCOCK RD.
Second Line	:	STE.220
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229
Country	:	US
Telephone Number	:	210-593-0373
Fax Number	:	210-593-0042

Provider Business Practice Location Address
First Line	:	2140 BABCOCK RD
Second Line	:	STE. 220
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-4424
Country	:	US
Telephone Number	:	210-593-0373
Fax Number	:	210-593-0042

Authorized Official
Title or Position	:	C.E.O
Name	:	MR. EDWARD RAMIREZ
Credential	:
Telephone Number	:	210-593-0373

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	08/22/2020

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