# LOTUS DIAGNOSTICS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770066045
- **Authorized official:** GINA SULLIVAN (BILLING MANAGER)
- **Authorized official phone:** (214) 269-3875

## Contact information

- **Practice address:** 8 RED HILL LN, S BARRINGTON, IL 60010-6188
- **Practice address phone:** (214) 269-3875
- **Practice address fax:** (903) 328-6568
- **Mailing address:** 111 BOLAND ST STE 211, FT WORTH, TX 76107-1265

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204R00000X | Electrodiagnostic Medicine Physician | — | NULL | Yes |
| 204R00000X | Electrodiagnostic Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/12/2018
- **Last updated:** 09/12/2018