Provider Demographics
NPI:1982860680
Name:HEALTHTRONICS LABORATORY SOLUTIONS LLC
Entity Type:Organization
Organization Name:HEALTHTRONICS LABORATORY SOLUTIONS LLC
Other - Org Name:UROPATH, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR, CBO
Authorized Official - Prefix:MRS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-314-4331
Mailing Address - Street 1:PO BOX 842184
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-2184
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7909 FREDERICKSBURG RD
Practice Address - Street 2:SUITE 233
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3425
Practice Address - Country:US
Practice Address - Phone:210-521-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-01
Last Update Date:2010-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXCL1037OtherMEDICARE GROUP
TX2101537Medicaid