Provider Demographics
NPI:1538904388
Name:ACTION POTENTIAL, LLC - A DIAGNOSTIC COMPANY
Entity type:Organization
Organization Name:ACTION POTENTIAL, LLC - A DIAGNOSTIC COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:CAZARES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:915-691-8009
Mailing Address - Street 1:9001 CASHEW DR STE 200C
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79907-2967
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9001 CASHEW DR STE 200C
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79907-2967
Practice Address - Country:US
Practice Address - Phone:915-691-8009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty