Provider Demographics
NPI:1700046901
Name:GM DIAGNOSTICS, PLLC
Entity Type:Organization
Organization Name:GM DIAGNOSTICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:LYAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-877-4846
Mailing Address - Street 1:4712 THORNTREE DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-2490
Mailing Address - Country:US
Mailing Address - Phone:469-877-4846
Mailing Address - Fax:888-797-7870
Practice Address - Street 1:4712 THORNTREE DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2490
Practice Address - Country:US
Practice Address - Phone:469-877-4846
Practice Address - Fax:888-797-7870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFTUVC2Medicare PIN