Provider Demographics
NPI:1467933184
Name:MEDPOINT MANAGEMENT GROUP, LLC
Entity Type:Organization
Organization Name:MEDPOINT MANAGEMENT GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUDWICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-848-7370
Mailing Address - Street 1:4841 KELLER SPRINGS RD STE B
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-5912
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4841 KELLER SPRINGS RD STE B
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-5912
Practice Address - Country:US
Practice Address - Phone:469-848-7370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory