Provider Demographics
NPI:1255821435
Name:AXIOM HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:AXIOM HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ROMANY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCENTURFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-541-2786
Mailing Address - Street 1:5422 ALPHA RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-4506
Mailing Address - Country:US
Mailing Address - Phone:214-451-2786
Mailing Address - Fax:
Practice Address - Street 1:5422 ALPHA RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240
Practice Address - Country:US
Practice Address - Phone:214-451-2786
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-14
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Multi-Specialty