Provider Demographics
NPI:1326223041
Name:HM CENTRAL LAB, LLC
Entity Type:Organization
Organization Name:HM CENTRAL LAB, LLC
Other - Org Name:HEALTH MATTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTO
Authorized Official - Middle Name:
Authorized Official - Last Name:ENRIQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:214-274-3478
Mailing Address - Street 1:2944 MOTLEY DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-3405
Mailing Address - Country:US
Mailing Address - Phone:972-613-5793
Mailing Address - Fax:972-613-7236
Practice Address - Street 1:2944 MOTLEY DR
Practice Address - Street 2:SUITE 105
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-3460
Practice Address - Country:US
Practice Address - Phone:972-613-5793
Practice Address - Fax:972-613-7236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2083P0901X, 291U00000X
TX45D1014980291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical LaboratoryGroup - Single Specialty
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45D1014980Medicare PIN