Life-Like Laboratory LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

LIFE-LIKE LABORATORY LLC

Doing business as

Life-Like Laboratory

Practice address

1548 Valwood Pkwy Ste 108
Carrollton, TX 75006-6859

Phone

(972) 620-0203

Fax

(972) 620-0204

NPI assigned

Mar 15, 2006

Last updated

Jun 9, 2022By 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

Crystal Fancher

Title

Owner

Phone

(972) 620-0203

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Life-Like Laboratory Doing business as

Locations

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654732800000",
    "number": "1114996832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1548 VALWOOD PKWY STE 108",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750066859",
            "telephone_number": "972-620-0203",
            "fax_number": "972-620-0204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1548 VALWOOD PKWY STE 108",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750066859",
            "telephone_number": "972-620-0203",
            "fax_number": "972-620-0204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE-LIKE LABORATORY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-15",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A",
        "authorized_official_last_name": "FANCHER",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-620-0203"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "507603",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Life-Like Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Prosthetic/Orthotic Supplier in Carrollton, TX
• Providers in Carrollton, TX by specialty
• Prosthetic/Orthotic Supplier in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.