Provider Demographics
NPI:1548911597
Name:DIANTE AND JAVANNA ARMSTRONG LLC
Entity type:Organization
Organization Name:DIANTE AND JAVANNA ARMSTRONG LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAVANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMSTRONG
Authorized Official - Suffix:
Authorized Official - Credentials:AGNP-C
Authorized Official - Phone:931-249-4341
Mailing Address - Street 1:1183 W ALAMOSA DR
Mailing Address - Street 2:
Mailing Address - City:TERRELL
Mailing Address - State:TX
Mailing Address - Zip Code:75160-7361
Mailing Address - Country:US
Mailing Address - Phone:931-249-4341
Mailing Address - Fax:
Practice Address - Street 1:1183 W ALAMOSA DR
Practice Address - Street 2:
Practice Address - City:TERRELL
Practice Address - State:TX
Practice Address - Zip Code:75160-7361
Practice Address - Country:US
Practice Address - Phone:931-249-4341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-11
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory