Organization
USMD DIAGNOSTIC SERVICES, LLC
Active
Other names
Texas Clinical Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL W BUKOSKY (PRESIDENT PPM)
(972) 847-0712
Entity
Organization
Contact information
Practice address
6333 NORTH STATE HIGHWAY 161, SUITE 200, IRVING, TX 75038-4049
(817) 514-5200
(817) 514-5210
Mailing address
PO BOX 678168, DALLAS, TX 75267-8168
(972) 847-0712
(817) 514-5246
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
04/09/2012
Last updated
11/08/2016
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