Provider Demographics
NPI:1275521825
Name:HKA CORPORATION
Entity Type:Organization
Organization Name:HKA CORPORATION
Other - Org Name:TRANS PECOS LABORATORY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:IRMA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-447-2808
Mailing Address - Street 1:1010 S. EDDY ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:PECOS
Mailing Address - State:TX
Mailing Address - Zip Code:79772-6902
Mailing Address - Country:US
Mailing Address - Phone:432-447-2808
Mailing Address - Fax:432-447-3909
Practice Address - Street 1:1010 S EDDY ST
Practice Address - Street 2:SUITE C
Practice Address - City:PECOS
Practice Address - State:TX
Practice Address - Zip Code:79772-6902
Practice Address - Country:US
Practice Address - Phone:432-447-2808
Practice Address - Fax:432-447-3909
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:H K A CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-10-07
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45D0055406291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0900953-02Medicaid
TXCL0049OtherMEDICARE PROVIDER NUMBER