MEDICARE: EMAR DIAGNOSTIC SERVICES

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	:	1669712436
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMAR DIAGNOSTIC SERVICES

Provider Business Mailing Address
First Line	:	1485 FM 1960 ROAD EAST BYPASS
Second Line	:	100
City	:	HUMBLE
State	:	TX
Zip	:	77338
Country	:	US
Telephone Number	:	281-394-3031
Fax Number	:	281-318-7696

Provider Business Practice Location Address
First Line	:	17735 ROUGH RIVER CT
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77346-8265
Country	:	US
Telephone Number	:	281-394-3031
Fax Number	:	281-318-7696

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	CHUKWUEMEKA LAWRENCE ORAGWU
Credential	:	MD
Telephone Number	:	281-394-3031

Provider Enumeration Date	:	02/15/2013
Last Update Date	:	02/15/2013

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Directions to “EMAR DIAGNOSTIC SERVICES ” Practice Location

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