Organization
PRE DIABETES PHYSICIAN SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDY MARFIN (CEO)
(512) 623-4919
Entity
Organization
Contact information
Practice address
12603 SOUTHWEST FWY STE 600, STAFFORD, TX 77477-3838
(512) 623-4900
Mailing address
3721 EXECUTIVE CENTER DR STE 160, AUSTIN, TX 78731-1607
(512) 623-4900
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
J4115
TX
Other
Enumeration date
05/19/2014
Last updated
05/19/2014
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