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Organization

CENTER FOR DISEASE DETECTION LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KIMBERLY T WILLIAMS (VICE PRESIDENT)
(800) 222-7566
Entity
Organization

Contact information

Practice address
11603 CROSSWINDS WAY STE 100, SAN ANTONIO, TX 78233-6005
(210) 590-3033
(210) 590-3121
Mailing address
PO BOX 659509, SAN ANTONIO, TX 78265-9509
(210) 590-3033
(210) 590-3121

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
003126019
CONNECTICUT
01
033332
FAMILY HEALTH PARTNERS
01
0793742
COLORADO MEDICAID
CO
01
095210302
AMERIGROUP TEXAS INC
05
095210302
TX
01
156260709
ARKANSAS MEDICAID
AR
01
20039659
AMERIHEALTH MERCY
01
232921142000
CARESOURCE
01
565848
CCN
01
690000009
ALABAMA MEDICAID
AL
01
7106123
ADAPTIS
01
730813
BUCKEYE COMMUNITY PLAN
01
976813
ARIZONA MEDICAID
01
CL5132
BLUECROSS BLUESHIELD
TX
01
LB142TX
ALASKA MEDICAID
01
XLAB60475
CALIFORNIA MEDI-CAL
CA
Enumeration date
10/03/2006
Last updated
12/14/2017
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