MEDICARE: NEW WORLD DX 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
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1740894914
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW WORLD DX LLC

Provider Business Mailing Address
First Line	:	8285 EL RIO ST STE 130
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-4654
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8285 EL RIO ST STE 130
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-4654
Country	:	US
Telephone Number	:	833-693-9888
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LILLIAN THAI
Credential	:
Telephone Number	:	833-693-9888

Provider Enumeration Date	:	09/03/2020
Last Update Date	:	09/03/2020

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Directions to “NEW WORLD DX LLC ” Practice Location

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