Provider Demographics
NPI:1730136821
Name:WILLIAM R. JANACEK
Entity Type:Organization
Organization Name:WILLIAM R. JANACEK
Other - Org Name:CARDIO PULMONARY DIAGNOSTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:JANACEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-886-1067
Mailing Address - Street 1:1209 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:COMMERCE
Mailing Address - State:TX
Mailing Address - Zip Code:75428-2613
Mailing Address - Country:US
Mailing Address - Phone:903-886-1067
Mailing Address - Fax:903-886-4501
Practice Address - Street 1:1209 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:COMMERCE
Practice Address - State:TX
Practice Address - Zip Code:75428-2613
Practice Address - Country:US
Practice Address - Phone:903-886-1067
Practice Address - Fax:903-886-4501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFTP006Medicare ID - Type Unspecified
TXFTP014Medicare ID - Type Unspecified