Organization
AVALON DIAGNOSTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHANDRA MCKENZIE (OWER/DIRECTOR)
(903) 892-6496
Entity
Organization
Contact information
Practice address
2009 INDEPENDENCE DR, SUITE 103, SHERMAN, TX 75090-0215
(903) 892-6496
(903) 892-6368
Mailing address
2009 INDEPENDENCE DR, SUITE 103, SHERMAN, TX 75090-0215
(903) 892-6496
(903) 892-6368
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FTS188
MEDICARE PTAN
TX
Enumeration date
02/19/2008
Last updated
11/20/2015
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