Provider Demographics
NPI:1235369877
Name:BIOPHYSICAL CORPORATION
Entity Type:Organization
Organization Name:BIOPHYSICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:RODGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-623-4900
Mailing Address - Street 1:3721 EXECUTIVE CENTER DR
Mailing Address - Street 2:160
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-1645
Mailing Address - Country:US
Mailing Address - Phone:512-623-4900
Mailing Address - Fax:512-623-4950
Practice Address - Street 1:3721 EXECUTIVE CENTER DR STE 160
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-1607
Practice Address - Country:US
Practice Address - Phone:512-623-4900
Practice Address - Fax:512-623-4950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-16
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45D2008896291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory