Mycodart Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MYCODART INC

Practice address

4100 Fairway Dr Ste 640
Carrollton, TX 75010-6525

Phone

(972) 492-0419

Fax

(972) 243-7759

NPI assigned

Nov 7, 2019

Last updated

Nov 7, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jeffrey Hooper

Title

Cfo

Phone

(972) 492-0419

Specialties & licenses 1

Addresses

Other identifiers 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Realtime Laboratories, Inc

  • Clinical Medical Laboratory
  • Carrollton, TX
  • NPI 1093099558

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Vincent E Bolton, M.D.

  • Anesthesiology Physician
  • Kennebunkport, ME
  • NPI 1821128828
  NPD (past)

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

{
    "created_epoch": "1573084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573084800000",
    "number": "1023653623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 FAIRWAY DR STE 640",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750106525",
            "telephone_number": "972-492-0419",
            "fax_number": "972-243-7759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 FAIRWAY DR STE 640",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750106525",
            "telephone_number": "972-492-0419",
            "fax_number": "972-243-7759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYCODART INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-07",
        "last_updated": "2019-11-07",
        "status": "A",
        "authorized_official_last_name": "HOOPER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "972-492-0419",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "45D2158080",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• McKenzie Leigh Musgrove
• Mutual Healthcare Systems Inc (Mutual Home Healthcare)
• Beatrice Muturi
• Lydia Mwesigwa, DNP-FNP
• My Heart Medicals LLC
• Ravi Mydur, M.D.
• Kevin Duane Myer, D.P.M.
• Jennifer Guadalupe Myers, DC
• Kevin R Myers, MD
• Miranda Myers

• Clinical Medical Laboratory in Carrollton, TX
• Providers in Carrollton, TX by specialty
• Clinical Medical Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; 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.