| Essential Care Diagnostic Services, Llc | |
|
1636 N Hampton Rd Ste 104b Desoto TX 75115-8600 | |
| (972) 972-0698 | |
| Not Available |
| Full Name | Essential Care Diagnostic Services, Llc |
|---|---|
| Speciality | Clinical Medical Laboratory |
| Location | 1636 N Hampton Rd Ste 104b, Desoto, Texas |
| Authorized Official Name and Position | Charlotte L Johnson (MANAGING OFFICER) |
| Authorized Official Contact | 9729720698 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Essential Care Diagnostic Services, Llc 1636 N Hampton Rd Ste 104b Desoto TX 75115-8600 Ph: (972) 972-0698 | Essential Care Diagnostic Services, Llc 1636 N Hampton Rd Ste 104b Desoto TX 75115-8600 Ph: (972) 972-0698 |
| NPI Number | 1326621939 |
|---|---|
| Provider Enumeration Date | 05/02/2021 |
| Last Update Date | 01/18/2022 |
| Medicare PECOS PAC ID | 6002212537 |
|---|---|
| Medicare Enrollment ID | O20210909001325 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326621939 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 291U00000X | Clinical Medical Laboratory | (* (Not Available)) | Primary |
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