MEDICARE: COMPLETE 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	227800000X	Certified Respiratory Therapist
2	291U00000X	Clinical Medical Laboratory	150211	TX
3	293D00000X	Physiological Laboratory
4	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659424992
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPLETE DIAGNOSTICS

Provider Business Mailing Address
First Line	:	102 BABCOCK RD
Second Line	:	STE 103
City	:	SAN ANTONIO
State	:	TX
Zip	:	78201-3952
Country	:	US
Telephone Number	:	210-248-9636
Fax Number	:	210-479-4057

Provider Business Practice Location Address
First Line	:	102 BABCOCK RD
Second Line	:	STE 103
City	:	SAN ANTONIO
State	:	TX
Zip	:	78201-3952
Country	:	US
Telephone Number	:	210-248-9636
Fax Number	:	210-479-4057

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	ERIKA QUINTANILLA
Credential	:
Telephone Number	:	210-559-5549

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	11/03/2020

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Directions to “COMPLETE DIAGNOSTICS ” Practice Location

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