Organization
MEDICAL EXERCISE TESTING SERVICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL GRAHAM (PRESIDENT, CEO)
(972) 539-4427
Entity
Organization
Contact information
Practice address
3700 FORUMS DR, SUITE 112, FLOWER MOUND, TX 75028-1820
(972) 539-4427
(972) 874-2415
Mailing address
PO BOX 874, FULSHEAR, TX 77441-0874
(281) 346-0801
(281) 346-0802
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000092LM
BLUE CROSS/BLUE SHIELD
TX
01
—
0007260397
AETNA
TX
01
—
8P0250
BLUE CROSS HMO
TX
01
—
AS10466580001
CIGNA
TX
Enumeration date
05/08/2006
Last updated
08/22/2020
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