Texas Independent Diagnostic Testing Facility PLLC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

Legal business name

TEXAS INDEPENDENT DIAGNOSTIC TESTING FACILITY PLLC

Practice address

825 Watters Creek Blvd Ste 250
Allen, TX 75013-3770

Phone

(833) 715-0726

NPI assigned

Dec 11, 2020

Organization subpart

No

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

Authorized official

Name

Christopher N Parks

Title

Manager Member

Phone

(918) 550-3552

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610064000000",
    "number": "1083210256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8660 S PEORIA AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741322827",
            "telephone_number": "918-550-3552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 WATTERS CREEK BLVD STE 250",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750133770",
            "telephone_number": "833-715-0726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS INDEPENDENT DIAGNOSTIC TESTING FACILITY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-11",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "MANAGER MEMBER",
        "authorized_official_telephone_number": "918-550-3552"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physiological Laboratory in Allen, TX
• Providers in Allen, TX by specialty
• Physiological Laboratory in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; 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.