Inhealth Diagnostic, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

45D2117218 Issued in TX

Legal business name

INHEALTH DIAGNOSTIC, LLC

Practice address

17742 Preston Rd Suite #210
Dallas, TX 75252-6199

Phone

(972) 674-1913

Fax

(903) 224-8322

NPI assigned

Aug 22, 2016

Last updated

Jul 23, 2019By 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

Mr. Alexi Bethel

Title

Manager

Phone

(972) 674-1913

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Real Lab Other name

Locations

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

{
    "created_epoch": "1471824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563840000000",
    "number": "1598210353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17742 PRESTON RD SUITE #210",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752526199",
            "telephone_number": "972-674-1913",
            "fax_number": "903-224-8322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17742 PRESTON RD SUITE #210",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752526199",
            "telephone_number": "972-674-1913",
            "fax_number": "903-224-8322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INHEALTH DIAGNOSTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-22",
        "last_updated": "2019-07-23",
        "status": "A",
        "authorized_official_last_name": "BETHEL",
        "authorized_official_first_name": "ALEXI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "972-674-1913",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TX",
            "license": "45D2117218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "364590501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Real Lab",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• 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 Jul 23, 2019; 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.