Provider Demographics
NPI:1821849829
Name:AMICO DX LLC
Entity Type:Organization
Organization Name:AMICO DX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SATISH
Authorized Official - Middle Name:
Authorized Official - Last Name:DASS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-929-2808
Mailing Address - Street 1:900 S LOOP W STE 170
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-4632
Mailing Address - Country:US
Mailing Address - Phone:832-265-1914
Mailing Address - Fax:
Practice Address - Street 1:900 S LOOP W STE 170
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-4632
Practice Address - Country:US
Practice Address - Phone:832-265-1914
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory