East Texas Referral and Testing, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

45D2090810 Issued in TX

Legal business name

EAST TEXAS REFERRAL AND TESTING, LLC

Practice address

9301 N Central Expy
335D
Dallas, TX 75231-0806

Phone

(972) 630-6420

Fax

(972) 630-6421

NPI assigned

Mar 25, 2015

Organization subpart

No

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

Authorized official

Name

Dean Viskovich, ESQ.

Title

Vice President of Legal

Phone

(972) 630-6443

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1427241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505779200000",
    "number": "1407240740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9301 N CENTRAL EXPY",
            "address_2": "335D",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752310806",
            "telephone_number": "972-630-6420",
            "fax_number": "972-630-6421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9301 N CENTRAL EXPY",
            "address_2": "335D",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752310806",
            "telephone_number": "972-630-6420",
            "fax_number": "972-630-6421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TEXAS REFERRAL AND TESTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-25",
        "last_updated": "2017-09-19",
        "status": "A",
        "authorized_official_last_name": "VISKOVICH",
        "authorized_official_first_name": "DEAN",
        "authorized_official_title_or_position": "VICE PRESIDENT OF LEGAL",
        "authorized_official_telephone_number": "972-630-6443",
        "authorized_official_credential": "ESQ."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TX",
            "license": "45D2090810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• East Lake Dental, PLLC
• East Lake Pharmacy
• East Quarter Dental PLLC
• East Run Management, LTD. Company
• East Texas Clinical Laboratory LLC
• Cori East-Long, LPC
• Cara A East, MD
• Cassidy Eastburn, FNP-C
• Easter Seals North Texas
• Easter Seals North Texas, Inc.

• Clinical Medical Laboratory in Dallas, TX
• Providers in Dallas, 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 Sep 19, 2017; 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.