Organization
SMALL GIANT LLC
Active
Other names
Blue Star Diagnostics
Organization subpart
No
Provider details
NPI number
Authorized official
POORNIMA GOWTHAMAN (CEO)
(925) 314-5556
Entity
Organization
Contact information
Practice address
720 E PARK BLVD STE 102, PLANO, TX 75074-8844
(925) 314-5556
Mailing address
720 E PARK BLVD STE 102, PLANO, TX 75074-8844
(925) 314-5556
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
07/25/2023
Last updated
07/25/2023
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