Provider Demographics
NPI:1548434632
Name:OMNIPATH DIAGNOSTICS OF TEXAS, LLC
Entity type:Organization
Organization Name:OMNIPATH DIAGNOSTICS OF TEXAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:CYRUS
Authorized Official - Middle Name:S
Authorized Official - Last Name:MILANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-881-0400
Mailing Address - Street 1:5858 MAIN
Mailing Address - Street 2:STE 240
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034
Mailing Address - Country:US
Mailing Address - Phone:888-881-0400
Mailing Address - Fax:310-472-0121
Practice Address - Street 1:5858 MAIN
Practice Address - Street 2:STE 240
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034
Practice Address - Country:US
Practice Address - Phone:888-881-0400
Practice Address - Fax:310-472-0121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory