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Organization

COMPLETE MOBILE DIAGNOSTICS, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EDIC STEPHANIAN M.D. (PRESIDENT)
(972) 475-6683
Entity
Organization

Contact information

Practice address
4302 RUNNING BROOK DR, ROWLETT, TX 75088-9256
(972) 475-6683
Mailing address
4302 RUNNING BROOK DR, ROWLETT, TX 75088-9256
(972) 475-6683

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
208600000X
Surgery Physician
2086S0129X
Vascular Surgery Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1837437-01
TX
Enumeration date
06/26/2006
Last updated
08/28/2015
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