Provider Demographics
NPI:1114679164
Name:K&K CONSULTING LABS LLC
Entity Type:Organization
Organization Name:K&K CONSULTING LABS LLC
Other - Org Name:IHEART MY LABS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:FOMUNUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:832-692-0551
Mailing Address - Street 1:6303 FRISCO SQUARE BLVD APT 136
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-3493
Mailing Address - Country:US
Mailing Address - Phone:832-692-0551
Mailing Address - Fax:
Practice Address - Street 1:6303 FRISCO SQUARE BLVD APT 136
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-3493
Practice Address - Country:US
Practice Address - Phone:832-692-0551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-21
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory