Organization
SCREENING FOR LIFE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELE LEE (PRESIDENT)
(325) 692-4410
Entity
Organization
Contact information
Practice address
6410 BUFFALO GAP RD #C, ABILENE, TX 79606-6055
(325) 692-4410
Mailing address
PO BOX 2754, ABILENE, TX 79604-2754
(325) 692-4410
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QR0208X
Mobile Radiology Clinic/Center
Primary
—
—
293D00000X
Physiological Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0830DC
BLUE CROSS BLUE SHIELD
TX
01
—
262282
MEDICARE PTAN
—
05
—
316060801
—
TX
05
—
316060802
—
TX
Enumeration date
10/17/2012
Last updated
04/08/2021
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