Organization
PROMUS DIAGNOSTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VICTOR SANSONE III (OWNER)
(817) 778-9210
Entity
Organization
Contact information
Practice address
525 S KIMBALL AVE, SOUTHLAKE, TX 76092-8064
(817) 778-9210
(817) 778-9244
Mailing address
525 S KIMBALL AVE, SOUTHLAKE, TX 76092-8064
(817) 778-9210
(817) 778-9244
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
12/07/2018
Last updated
03/26/2026
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