MEDICARE: DYNAMIC RAPID RESULTS TESTING

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	246QL0900X	Laboratory Management Specialist/Technologist

General Provider Information

NPI Number	:	1164371472
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DYNAMIC RAPID RESULTS TESTING

Provider Business Mailing Address
First Line	:	6220 WESTPARK DR STE 149
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-7417
Country	:	US
Telephone Number	:	832-571-1182
Fax Number	:	713-583-0497

Provider Business Practice Location Address
First Line	:	19016 GOLDMAR CT
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77073
Country	:	US
Telephone Number	:	832-571-1182
Fax Number	:	713-583-0497

Authorized Official
Title or Position	:	OWNER
Name	:	CASEY DIYALE COLEMAN
Credential	:
Telephone Number	:	662-577-9855

Provider Enumeration Date	:	01/28/2026
Last Update Date	:	01/28/2026

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Directions to “DYNAMIC RAPID RESULTS TESTING ” Practice Location

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