MEDICARE: HEALTH SURVEY SCOUT 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	:	1902621121
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH SURVEY SCOUT LLC

Provider Business Mailing Address
First Line	:	11133 SHADY TRL
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75229-4617
Country	:	US
Telephone Number	:	224-224-5512
Fax Number	:	240-391-1040

Provider Business Practice Location Address
First Line	:	11133 SHADY TRL
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75229-4617
Country	:	US
Telephone Number	:	224-224-5512
Fax Number	:	240-391-1040

Authorized Official
Title or Position	:	OWNER
Name	:	MR. HARIS KHAN
Credential	:
Telephone Number	:	224-224-5512

Provider Enumeration Date	:	11/21/2024
Last Update Date	:	11/27/2025

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