Provider Demographics
NPI:1518225069
Name:MEDCARE DIAGNOSTICS OF AMERICA
Entity Type:Organization
Organization Name:MEDCARE DIAGNOSTICS OF AMERICA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RHYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:NYLAAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-856-4070
Mailing Address - Street 1:501 AVIATOR DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76179-5416
Mailing Address - Country:US
Mailing Address - Phone:800-856-4070
Mailing Address - Fax:817-439-3468
Practice Address - Street 1:501 AVIATOR DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76179-5416
Practice Address - Country:US
Practice Address - Phone:800-856-4070
Practice Address - Fax:817-439-3468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory