Provider Demographics
NPI:1023472891
Name:OMNIHEALTH DIAGNOSTICS LLC
Entity type:Organization
Organization Name:OMNIHEALTH DIAGNOSTICS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:WIRTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-887-3444
Mailing Address - Street 1:1840 N GREENVILLE AVE STE 176
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-6724
Mailing Address - Country:US
Mailing Address - Phone:972-887-3444
Mailing Address - Fax:972-887-3443
Practice Address - Street 1:1840 N GREENVILLE AVE STE 176
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-6724
Practice Address - Country:US
Practice Address - Phone:972-887-3444
Practice Address - Fax:972-887-3443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-07
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory