Provider Demographics
NPI:1275037574
Name:RDT TECHNOLOGIES LLC
Entity Type:Organization
Organization Name:RDT TECHNOLOGIES LLC
Other - Org Name:MB LASER THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-995-5935
Mailing Address - Street 1:3701 S COOPER ST STE 161
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-3466
Mailing Address - Country:US
Mailing Address - Phone:817-422-9211
Mailing Address - Fax:
Practice Address - Street 1:3701 S COOPER ST STE 161
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-3466
Practice Address - Country:US
Practice Address - Phone:817-422-9211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ32422081P2900X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty