Usmd Diagnostic Services, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

USMD DIAGNOSTIC SERVICES, LLC

Practice address

6333 North State Highway 161
Suite 200
Irving, TX 75038-4049

Phone

(817) 514-5200

Fax

(817) 514-5210

NPI assigned

Apr 9, 2012

Organization subpart

No

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

Authorized official

Name

Michael W Bukosky

Title

President PPM

Phone

(972) 847-0712

Specialties & licenses 1

Addresses

Other names 1

• Texas Clinical Laboratory Other name

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

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478563200000",
    "number": "1780940270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 678168",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752678168",
            "telephone_number": "972-847-0712",
            "fax_number": "817-514-5246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6333 NORTH STATE HIGHWAY 161",
            "address_2": "SUITE 200",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750384049",
            "telephone_number": "817-514-5200",
            "fax_number": "817-514-5210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USMD DIAGNOSTIC SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-09",
        "last_updated": "2016-11-08",
        "status": "A",
        "authorized_official_last_name": "BUKOSKY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT PPM",
        "authorized_official_telephone_number": "972-847-0712"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Texas Clinical Laboratory",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Clinical Medical Laboratory in Irving, TX
• Providers in Irving, 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 Nov 8, 2016; 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.