Protix Laboratory and Medical Group

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PROTIX LABORATORY AND MEDICAL GROUP

Practice address

8200 Stonebrook Pkwy
Frisco, TX 75034-5539

Phone

(903) 327-6412

NPI assigned

Jun 22, 2015

Organization subpart

Yes

Parent organization

NEW WAVE LABORATORY SERVICES, LLCAs reported in NPPES

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

Authorized official

Name

Ronni Hefner

Title

Ceo

Phone

(903) 327-6412

Specialties & licenses 2

Addresses

Other names 1

• New Wave Laboratory Services, LLC Former legal business name

Part of

Protix Laboratory and Medical Group

Locations

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590105600000",
    "number": "1679955140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 STONEBROOK PKWY STE 206",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750345588",
            "telephone_number": "903-327-6412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 STONEBROOK PKWY",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750345539",
            "telephone_number": "903-327-6412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROTIX LABORATORY AND MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEW WAVE LABORATORY SERVICES, LLC",
        "enumeration_date": "2015-06-22",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A",
        "authorized_official_last_name": "HEFNER",
        "authorized_official_first_name": "RONNI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "903-327-6412"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Wave Laboratory Services, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.