Small Giant LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

SMALL GIANT LLC

Doing business as

Blue Star Diagnostics

Practice address

720 E Park Blvd Ste 102
Plano, TX 75074-8844

Phone

(925) 314-5556

NPI assigned

Jul 25, 2023

Organization subpart

No

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

Authorized official

Name

Poornima Gowthaman

Title

Ceo

Phone

(925) 314-5556

Specialties & licenses 1

Addresses

Other names 1

• Blue Star Diagnostics Doing business as

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": "1690243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690243200000",
    "number": "1619658572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 E PARK BLVD STE 102",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750748844",
            "telephone_number": "925-314-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 E PARK BLVD STE 102",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750748844",
            "telephone_number": "925-314-5556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMALL GIANT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-25",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A",
        "authorized_official_last_name": "GOWTHAMAN",
        "authorized_official_first_name": "POORNIMA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "925-314-5556"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Star Diagnostics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Natalya Slobodkin, PA-C
• John E Slonaker, PT
• Todd V Sluder, M.A. LPC
• SM Labs LLC
• Pamela Ann Smale Williams, M.A., LPC, LMFT
• Small Witherspoon & Regan Endodontics Partnership LLC (Small and Witherspoon Endodontics Partnership LLP)
• Andrew Buchanan Small IV, MD
• Emily Dale Small
• Joel C Small, DDS
• Stuart D. Small, M.D.

• Clinical Medical Laboratory in Plano, TX
• Providers in Plano, 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 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.