Provider Demographics
NPI:1932849890
Name:MAXCARE DIAGNOSTICS
Entity Type:Organization
Organization Name:MAXCARE DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAB MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SAMEER HUSSAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-887-5235
Mailing Address - Street 1:3301 CONFLANS RD STE 107
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-6355
Mailing Address - Country:US
Mailing Address - Phone:972-887-5235
Mailing Address - Fax:
Practice Address - Street 1:3301 CONFLANS RD STE 107
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-6355
Practice Address - Country:US
Practice Address - Phone:972-887-5235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-30
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory