Provider Demographics
NPI:1619560778
Name:INTUIT TESTING LLC
Entity Type:Organization
Organization Name:INTUIT TESTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PUNIT
Authorized Official - Middle Name:KAMLESH
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-287-8044
Mailing Address - Street 1:2634 HIGHWAY 36 S
Mailing Address - Street 2:
Mailing Address - City:BRENHAM
Mailing Address - State:TX
Mailing Address - Zip Code:77833-9600
Mailing Address - Country:US
Mailing Address - Phone:844-546-8848
Mailing Address - Fax:844-546-8848
Practice Address - Street 1:2634 HIGHWAY 36 S
Practice Address - Street 2:
Practice Address - City:BRENHAM
Practice Address - State:TX
Practice Address - Zip Code:77833-9600
Practice Address - Country:US
Practice Address - Phone:833-483-7800
Practice Address - Fax:833-483-7800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-18
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45D2196895OtherCLIA