Provider Demographics
NPI:1952564676
Name:COMPLETE DIAGNOSTICS
Entity Type:Organization
Organization Name:COMPLETE DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:LATIOLAIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-599-1333
Mailing Address - Street 1:PO BOX 271825
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77277-1825
Mailing Address - Country:US
Mailing Address - Phone:713-599-1333
Mailing Address - Fax:866-804-4870
Practice Address - Street 1:12853 GULF FWY STE B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77034-4807
Practice Address - Country:US
Practice Address - Phone:713-599-1333
Practice Address - Fax:866-804-4870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-02
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service