Provider Demographics
NPI:1265184683
Name:CHOICES
Entity type:Organization
Organization Name:CHOICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANDALYN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-891-2522
Mailing Address - Street 1:4002 W PIONEER DR APT 114
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-8157
Mailing Address - Country:US
Mailing Address - Phone:972-891-2522
Mailing Address - Fax:
Practice Address - Street 1:4002 W PIONEER DR APT 114
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-8157
Practice Address - Country:US
Practice Address - Phone:972-891-2522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45D2248646OtherCLIA WAIVER