Provider Demographics
NPI:1861641888
Name:PROGENIKA, INC
Entity Type:Organization
Organization Name:PROGENIKA, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:ESTIBALIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:OLANO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:512-749-1649
Mailing Address - Street 1:201 CARLSON CIRCLE
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666
Mailing Address - Country:US
Mailing Address - Phone:512-749-1649
Mailing Address - Fax:512-749-1677
Practice Address - Street 1:201 CARLSON CIRCLE
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666
Practice Address - Country:US
Practice Address - Phone:512-749-1649
Practice Address - Fax:512-749-1677
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROGENIKA BIOPHARMA, S.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-15
Last Update Date:2015-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory