Provider Demographics
NPI:1023149317
Name:SGK DIAGNOSTICS, INC
Entity type:Organization
Organization Name:SGK DIAGNOSTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:BARRY
Authorized Official - Last Name:KUCHENBACKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-729-5260
Mailing Address - Street 1:1108 BALLY MOTE DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-3904
Mailing Address - Country:US
Mailing Address - Phone:214-729-5260
Mailing Address - Fax:214-220-9907
Practice Address - Street 1:1108 BALLY MOTE DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-3904
Practice Address - Country:US
Practice Address - Phone:214-729-5260
Practice Address - Fax:214-220-9907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Single Specialty