NPIMap

Organization Active NPI

Heritage Laboratory Systems

  • Clinical Medical Laboratory
  • Mesquite, TX
National Provider Identifier
1356638829
Registry record updated Aug 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
HERITAGE LABORATORY SYSTEMS
Practice address
15330 LBJ Fwy
Suite 301 Box 12
Mesquite, TX 75150-1223
Phone
(972) 698-0586
NPI assigned
Jul 6, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2011

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

Authorized official

Name
Mr. Raymond Eugene Davis Jr., MT
Title
Ceo
Phone
(972) 698-0586

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

15330 LBJ Fwy
Suite 301 Box 12
Mesquite, TX 75150-1223

Mailing address

15330 LBJ Fwy
Suite 301 Box 12
Mesquite, TX 75150-1223
Phone (972) 698-0586

Other names 1

  • Heritage Laboratory Mesquite Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312156800000",
    "number": "1356638829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15330 LBJ FWY",
            "address_2": "SUITE 301 BOX 12",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751501223",
            "telephone_number": "972-698-0586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15330 LBJ FWY",
            "address_2": "SUITE 301 BOX 12",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751501223",
            "telephone_number": "972-698-0586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERITAGE LABORATORY SYSTEMS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-06",
        "last_updated": "2011-08-01",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "972-698-0586",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MT"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heritage Laboratory Mesquite",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mesquite, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2011; 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.