Provider Demographics
NPI:1942603683
Name:HEATHER DIAGNOSTICS SERVICES
Entity Type:Organization
Organization Name:HEATHER DIAGNOSTICS SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHANDRESH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-939-8480
Mailing Address - Street 1:1229 CREEK WAY DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4559
Mailing Address - Country:US
Mailing Address - Phone:832-939-8480
Mailing Address - Fax:
Practice Address - Street 1:1229 CREEK WAY DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4559
Practice Address - Country:US
Practice Address - Phone:832-939-8480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-08
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory