Provider Demographics
NPI:1083288146
Name:STONE SPRINGS DX, LLC
Entity Type:Organization
Organization Name:STONE SPRINGS DX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-609-9435
Mailing Address - Street 1:10847 KUYKENDAHL RD STE 200B
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-2932
Mailing Address - Country:US
Mailing Address - Phone:346-370-8594
Mailing Address - Fax:
Practice Address - Street 1:10847 KUYKENDAHL RD STE 200B
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77382-2932
Practice Address - Country:US
Practice Address - Phone:346-370-8594
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-13
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory