Provider Demographics
NPI:1558977710
Name:PARATUS DIAGNOSTICS
Entity Type:Organization
Organization Name:PARATUS DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:MATULA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:512-484-2237
Mailing Address - Street 1:3055 HUNTER RD
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-6460
Mailing Address - Country:US
Mailing Address - Phone:512-484-2237
Mailing Address - Fax:
Practice Address - Street 1:3055 HUNTER RD
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-6460
Practice Address - Country:US
Practice Address - Phone:512-484-2237
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-22
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory