Provider Demographics
NPI:1407123912
Name:COUNTY DIAGNOSTICS INC
Entity type:Organization
Organization Name:COUNTY DIAGNOSTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NAVEEN
Authorized Official - Middle Name:K
Authorized Official - Last Name:BASEPOGU
Authorized Official - Suffix:
Authorized Official - Credentials:MBBS
Authorized Official - Phone:469-854-1624
Mailing Address - Street 1:1621 WESTFIELD WAY
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-6479
Mailing Address - Country:US
Mailing Address - Phone:469-854-1624
Mailing Address - Fax:469-854-1697
Practice Address - Street 1:1621 WESTFIELD WAY
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-6479
Practice Address - Country:US
Practice Address - Phone:469-854-1624
Practice Address - Fax:469-854-1697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-28
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonographyGroup - Single Specialty