Provider Demographics
NPI:1285030718
Name:EMPIRE DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:EMPIRE DIAGNOSTICS LLC
Other - Org Name:EMPIRE DIAGNOSTICS LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:CONCHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-420-0688
Mailing Address - Street 1:24 GREENWAY PLZ
Mailing Address - Street 2:SUITE 1705
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77046-2401
Mailing Address - Country:US
Mailing Address - Phone:832-649-4363
Mailing Address - Fax:
Practice Address - Street 1:24 GREENWAY PLZ
Practice Address - Street 2:SUITE 1705
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77046-2401
Practice Address - Country:US
Practice Address - Phone:832-649-4363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-11
Last Update Date:2014-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology