Igenomedx Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

IGENOMEDX INC.

Practice address

2040 Babcock Rd Ste 201
San Antonio, TX 78229-4428

Phone

(210) 257-6973

NPI assigned

Jun 19, 2016

Organization subpart

No

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

Authorized official

Name

Niti Vanee, PHD

Title

Ceo & President

Phone

(210) 257-6973

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1466294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649808000000",
    "number": "1225488455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 BABCOCK RD STE 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294428",
            "telephone_number": "210-257-6973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 BABCOCK RD STE 201",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294428",
            "telephone_number": "210-257-6973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IGENOMEDX INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-19",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A",
        "authorized_official_last_name": "VANEE",
        "authorized_official_first_name": "NITI",
        "authorized_official_title_or_position": "CEO & PRESIDENT",
        "authorized_official_telephone_number": "210-257-6973",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasmine Victoria Idrogo, MS, NCC, LPC
• Ieme
• Umbreen Iftekhar, PA-C
• Wara Iftikhar
• Igatundu-Texas Health, LLC
• Iyobosasere Ighoroje, AGACNP
• Nicole Iginiamre, NP
• Eric Francisco Iglesias Muniz, NP
• Mannhu Bui Iglesias, DDS
• Patricia Liz Iglesias

• Clinical Medical Laboratory in San Antonio, TX
• Providers in San Antonio, 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 Apr 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.