Provider Demographics
NPI:1902557085
Name:RGM DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:RGM DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:VELARDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-762-3742
Mailing Address - Street 1:4715 MERWIN ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-6607
Mailing Address - Country:US
Mailing Address - Phone:323-762-3742
Mailing Address - Fax:
Practice Address - Street 1:4715 MERWIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-6607
Practice Address - Country:US
Practice Address - Phone:323-762-3742
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory