Provider Demographics
NPI:1063961183
Name:CARDEX DIAGNOSTICS LLC
Entity type:Organization
Organization Name:CARDEX DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-900-9750
Mailing Address - Street 1:4411 BLUEBONNET DR
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-2912
Mailing Address - Country:US
Mailing Address - Phone:281-900-9750
Mailing Address - Fax:832-442-3973
Practice Address - Street 1:4411 BLUEBONNET DR
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-2912
Practice Address - Country:US
Practice Address - Phone:281-900-9750
Practice Address - Fax:832-442-3973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-30
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty