Provider Demographics
NPI:1275869992
Name:FIRST CHOICE DIAGNOSTICS
Entity Type:Organization
Organization Name:FIRST CHOICE DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:VASQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-207-9635
Mailing Address - Street 1:945 FREER PL
Mailing Address - Street 2:
Mailing Address - City:ALICE
Mailing Address - State:TX
Mailing Address - Zip Code:78332-3878
Mailing Address - Country:US
Mailing Address - Phone:361-207-9635
Mailing Address - Fax:
Practice Address - Street 1:1629 E MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:ALICE
Practice Address - State:TX
Practice Address - Zip Code:78332-4045
Practice Address - Country:US
Practice Address - Phone:361-207-9635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-30
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory