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NPI Code Detail

MEDICARE: TEXAS DX LABORATORIES LLC

MEDICARE: TEXAS DX LABORATORIES 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
1291U00000XClinical Medical Laboratory

General Provider Information

NPI Number : 1568253706
Entity Type Code : Organization
Provider Name (Legal Business Name) : TEXAS DX LABORATORIES LLC
Provider Business Mailing Address
First Line : 17290 PRESTON RD STE 203
Second Line :
City : DALLAS
State : TX
Zip : 75252-4028
Country : US
Telephone Number : 773-516-7468
Fax Number :
Provider Business Practice Location Address
First Line : 17290 PRESTON RD STE 203
Second Line :
City : DALLAS
State : TX
Zip : 75252-4028
Country : US
Telephone Number : 773-516-7468
Fax Number :
Authorized Official
Title or Position : PRACTICE OWNER
Name : KAZBEK AMBALOV
Credential :
Telephone Number : 312-296-8925
Provider Enumeration Date : 05/15/2025
Last Update Date : 05/22/2026

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Directions to “TEXAS DX LABORATORIES LLC ” Practice Location

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