Provider Demographics
NPI:1407273444
Name:DMM LAB LLC
Entity Type:Organization
Organization Name:DMM LAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HUSSAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABBAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-382-7288
Mailing Address - Street 1:1521 MAPLEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-6019
Mailing Address - Country:US
Mailing Address - Phone:972-382-7288
Mailing Address - Fax:
Practice Address - Street 1:1521 MAPLEVIEW DR
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-6019
Practice Address - Country:US
Practice Address - Phone:972-382-7288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-27
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory