Provider Demographics
NPI:1710749825
Name:SMART TESTING LABS & PHYSICIAN CARE PRACTICE PLLC
Entity Type:Organization
Organization Name:SMART TESTING LABS & PHYSICIAN CARE PRACTICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANUM
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-280-7931
Mailing Address - Street 1:12350 MONTWOOD DR STE 300
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79928-5695
Mailing Address - Country:US
Mailing Address - Phone:915-800-1115
Mailing Address - Fax:915-800-1113
Practice Address - Street 1:12350 MONTWOOD DR STE 300
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79928-5695
Practice Address - Country:US
Practice Address - Phone:915-800-1115
Practice Address - Fax:915-800-1113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-24
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty