Provider Demographics
NPI:1598364358
Name:PRO DIAGNOSTICS PLLC
Entity Type:Organization
Organization Name:PRO DIAGNOSTICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD TECHNOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:VU
Authorized Official - Suffix:
Authorized Official - Credentials:CNIM
Authorized Official - Phone:214-505-9345
Mailing Address - Street 1:7504 SAN JACINTO PL
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3233
Mailing Address - Country:US
Mailing Address - Phone:469-653-3886
Mailing Address - Fax:
Practice Address - Street 1:7504 SAN JACINTO PL
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3233
Practice Address - Country:US
Practice Address - Phone:469-653-3886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology