Organization
HEALTHSPAN360
Active
Organization
HEALTHSPAN360
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID JEFFREY LUTZ (CHAIRMAN)
(281) 543-3174
Entity
Organization
Contact information
Practice address
16922 TELGE RD STE 2K, CYPRESS, TX 77429-1108
(281) 543-3174
Mailing address
14751 OLD BANDERA RD APT 3202, HELOTES, TX 78023-2284
(281) 543-3174
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45D2326543
CLIA
TX
Enumeration date
08/11/2026
Last updated
08/11/2026
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