Prostick Mobile Labs LLC

Organization Active NPI Phlebotomy Technician · Joshua, TX

NPI 1205526993 · NPPES record last updated May 9, 2023

Key facts

NPI
1205526993
Entity type
Organization (NPI type 2)
Primary specialty
Phlebotomy Technician 246RP1900X
Legal business name
PROSTICK MOBILE LABS LLC
Practice address
5909 Short Cake LN
Joshua, TX 76058-6402
Phone
(817) 933-2394
Fax
(817) 549-7848
NPI assigned
May 8, 2023
Organization subpart
No

Authorized official

Name
Rominique Palomino, PBT
Title
Owner/Ceo
Phone
(817) 933-2394

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20230611000036 TX Part B Supplier - Independent Clinical Laboratory 1153788864 Practice locations: Joshua, TX

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy Technician
Group: 193400000X SINGLE SPECIALTY GROUP
246RP1900X Yes

Addresses

Primary practice location

5909 Short Cake LN
Joshua, TX 76058-6402

Mailing address

5909 Short Cake LN
Joshua, TX 76058-6402
Phone (817) 933-2394

Other providers in Joshua, TX

All providers in Joshua, TX · Phlebotomy Technician in Texas

Sources for this page

Verify at the official NPI Registry.