Organization
LUCENTA LABORATORY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SATISH CHUNDRU D.O. (DIRECTOR)
(972) 294-5076
Entity
Organization
Contact information
Practice address
7589 PRESTON RD, SUITE 900, FRISCO, TX 75034-5667
(972) 294-5076
(972) 294-5235
Mailing address
7589 PRESTON RD, SUITE 900, FRISCO, TX 75034-5667
(972) 294-5076
(972) 294-5235
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
45D2081612
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M9927
TEXAS MEDICAL BOARD LICENSE
TX
Enumeration date
01/27/2015
Last updated
01/27/2015
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