Provider Demographics
NPI:1356931141
Name:TEVIDO BIODEVICES, INC
Entity type:Organization
Organization Name:TEVIDO BIODEVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-640-3295
Mailing Address - Street 1:10931 JOLLYVILLE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5673
Mailing Address - Country:US
Mailing Address - Phone:512-640-3295
Mailing Address - Fax:
Practice Address - Street 1:10931 JOLLYVILLE RD STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-5673
Practice Address - Country:US
Practice Address - Phone:512-640-3295
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory