Active NPI
Azmat Shah
- Clinical Medical Laboratory
- Irving, TX
National Provider Identifier
1922489541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- License
- 45D2095863
- Practice address
- 813 N. O'Connor Road
Irving, TX 75061 - Phone
- (855) 890-9589
- Fax
- (855) 395-9673
- NPI assigned
- Jun 10, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 45D2095863 | TX | Primary |
Addresses
Primary practice location
813 N. O'Connor Road
Irving, TX 75061
Mailing address
813 N. O'Connor Road
Irving, TX 75061
Phone (855) 890-9589
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 45D2095863 | TX | MD | Clinical Medical Laboratory |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gibson Diagnostic Labs, LLC | Clinical Medical Laboratory | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical Medical Laboratory
- Irving, TX
- NPI 1386023620
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433894400000",
"number": "1922489541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "813 N. O'CONNOR ROAD",
"city": "IRVING",
"state": "TX",
"postal_code": "75061",
"telephone_number": "855-890-9589",
"fax_number": "855-395-9673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "813 N. O'CONNOR ROAD",
"city": "IRVING",
"state": "TX",
"postal_code": "75061",
"telephone_number": "855-890-9589",
"fax_number": "855-395-9673"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "AZMAT",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-06-10",
"last_updated": "2015-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": "TX",
"license": "45D2095863",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irving, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.