Provider Demographics
NPI:1063280840
Name:ALPHA DIAGNOSTIXS LLC
Entity type:Organization
Organization Name:ALPHA DIAGNOSTIXS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEVETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCULLUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-625-7903
Mailing Address - Street 1:8035 E R L THORNTON FWY STE 266
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-0002
Mailing Address - Country:US
Mailing Address - Phone:504-205-2148
Mailing Address - Fax:972-551-4119
Practice Address - Street 1:8035 E R L THORNTON FWY STE 266
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-0002
Practice Address - Country:US
Practice Address - Phone:504-205-2148
Practice Address - Fax:972-551-4119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-12
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty