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Contact Information

INDEPENDENT MOBIL DIAGNOSTICE TESTING FACILITY
1661 WOODARD AVE
SUITE 110
CLEBURNE, TX76033-7052
 Phone: 817-494-6875
 Fax:
 Website:
Indicates primary specialty

NPI Profile & details for INDEPENDENT MOBIL DIAGNOSTICE TESTING FACILITY

NPI # 1437434206
LBN Legal business name INDEPENDENT MOBIL DIAGNOSTICE TESTING FACILITY
Authorized official EDMOND MAXON - (ED)
Entity Organization
Organization subpart 1 No
Enumeration date 10/12/2011
Last updated 10/12/2011 - About 15 years ago
Identifiers
TX License # 22799
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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