Provider Demographics
NPI:1750036109
Name:DMI HEALTHCARE SERVICES, LLC
Entity Type:Organization
Organization Name:DMI HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:D
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-402-0282
Mailing Address - Street 1:1103 ALEXIS CT STE 107
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-3338
Mailing Address - Country:US
Mailing Address - Phone:214-402-0282
Mailing Address - Fax:214-397-4600
Practice Address - Street 1:323 W PARK PLACE DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75134-3251
Practice Address - Country:US
Practice Address - Phone:214-402-0282
Practice Address - Fax:214-397-4600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-15
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45D2252722OtherCLIA