Provider Demographics
NPI:1891325288
Name:RADIX DIAGNOSTICS LLC
Entity Type:Organization
Organization Name:RADIX DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL CARE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZWIERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-302-2753
Mailing Address - Street 1:38400 INTERSTATE 10 W APT A
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-9001
Mailing Address - Country:US
Mailing Address - Phone:210-790-9631
Mailing Address - Fax:
Practice Address - Street 1:17301 N PERIMETER DR STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-5468
Practice Address - Country:US
Practice Address - Phone:602-857-8378
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-24
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory