Provider Demographics
NPI:1104216605
Name:PHR DIAGNOSTICS, LLC
Entity Type:Organization
Organization Name:PHR DIAGNOSTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SOBEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-210-6969
Mailing Address - Street 1:34 SANDY BROOK DR
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-1214
Mailing Address - Country:US
Mailing Address - Phone:347-210-6969
Mailing Address - Fax:214-396-9441
Practice Address - Street 1:13601 PRESTON RD STE 1050E
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-4927
Practice Address - Country:US
Practice Address - Phone:469-913-7042
Practice Address - Fax:516-534-2074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-04
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
291U00000X
TX291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory