Complete Mobile Diagnostics, PA

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

COMPLETE MOBILE DIAGNOSTICS, PA

Practice address

4302 Running Brook Dr
Rowlett, TX 75088-9256

Phone

(972) 475-6683

NPI assigned

Jun 26, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Edic Stephanian, M.D.

Title

President

Phone

(972) 475-6683

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440720000000",
    "number": "1023045374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4302 RUNNING BROOK DR",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750889256",
            "telephone_number": "972-475-6683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4302 RUNNING BROOK DR",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750889256",
            "telephone_number": "972-475-6683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE MOBILE DIAGNOSTICS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2015-08-28",
        "status": "A",
        "authorized_official_last_name": "STEPHANIAN",
        "authorized_official_first_name": "EDIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-475-6683",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1837437-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Rowlett, TX
• Providers in Rowlett, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.