BNB Diagnostics, LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

BNB DIAGNOSTICS, LLC

Practice address

350 Nursery Rd Ste 3102
Spring, TX 77380-4079

Phone

(346) 351-1203

NPI assigned

Sep 8, 2020

Last updated

Nov 15, 2021By 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

Brennen Lark

Title

Officer

Phone

(504) 494-3543

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• BNB Diagnostics

  • Clinical Medical Laboratory
  • Spring, TX
  • NPI 1770153090

  O20210610003178

  Same enrollment

Locations

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

{
    "created_epoch": "1599523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636934400000",
    "number": "1417561358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 NURSERY RD STE 3102",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773804079",
            "telephone_number": "346-351-1203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 NURSERY RD STE 3102",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773804079",
            "telephone_number": "346-351-1203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BNB DIAGNOSTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-08",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A",
        "authorized_official_last_name": "LARK",
        "authorized_official_first_name": "BRENNEN",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "504-494-3543"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical & Laboratory Immunology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• BNB Diagnostics
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• Yessika Boada, RN
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• Mary Bob
• Erica Renee Bock, D.D.S.

• General Practice Physician in Spring, TX
• Providers in Spring, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.