Organization
ENTERRA MEDICAL DIAGNOSTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL KALUARACHI (OWNER)
(214) 467-7434
Entity
Organization
Contact information
Practice address
5787 S HAMPTON RD, STE 255, DALLAS, TX 75232-2255
(214) 330-7030
(214) 330-7073
Mailing address
5787 S HAMPTON RD, STE 450, DALLAS, TX 75232-2255
(214) 467-7434
(214) 467-7434
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0076258
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
179148501
—
TX
05
—
179148502
—
TX
Enumeration date
10/31/2006
Last updated
03/21/2011
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