Innovative Genomics LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

INNOVATIVE GENOMICS LLC

Practice address

5410 Fredericksburg Rd
Suite 304
San Antonio, TX 78229

Phone

(210) 352-5175

NPI assigned

Apr 6, 2019

Last updated

May 20, 2020By 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

Diego Sanchez Sanudo Chocron

Title

Cfo

Phone

(310) 985-2834

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary Michelle Malkin, PHARMD

  • Pharmacist
  • San Antonio, TX
  • NPI 1689330144
  NPD

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

{
    "created_epoch": "1554508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589932800000",
    "number": "1629531769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 FREDERICKSBURG RD STE 304",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293576",
            "telephone_number": "210-351-5175",
            "fax_number": "210-352-5175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5410 FREDERICKSBURG RD",
            "address_2": "SUITE 304",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78229",
            "telephone_number": "210-352-5175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE GENOMICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-06",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A",
        "authorized_official_last_name": "CHOCRON",
        "authorized_official_first_name": "DIEGO",
        "authorized_official_middle_name": "SANCHEZ SANUDO",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "310-985-2834"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "45D2155835",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Inniss-Thompson, OTR
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• Innovative Independence Inc. (Para Driving Aids)
• Innovative Medicine, Inc (Thyroid & Endocrine Center of South Texas)
• Innovative Occupational Therapy
• Innovative Senior Care Home Health of San Antonio LLC (Methodist Healthcare at Home)

• Clinical Medical Laboratory in San Antonio, TX
• Providers in San Antonio, 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 May 20, 2020; 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.