Provider Demographics
NPI:1760061352
Name:PEAK HEALTH DIAGNOSTICS, LLC
Entity Type:Organization
Organization Name:PEAK HEALTH DIAGNOSTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:IMRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-434-9239
Mailing Address - Street 1:1605 N GARLAND AVE STE A
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-9418
Mailing Address - Country:US
Mailing Address - Phone:312-434-9239
Mailing Address - Fax:
Practice Address - Street 1:1605 N GARLAND AVE STE A
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-9418
Practice Address - Country:US
Practice Address - Phone:312-434-9239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-02
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory