Organization
ENVISION MEDICAL MANAGEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAITANYA CHAVDA MD (DIRECTOR)
(313) 505-2932
Entity
Organization
Contact information
Practice address
4927 LAKE RIDGE PKWY STE 148, GRAND PRAIRIE, TX 75052-3087
(313) 505-2932
Mailing address
4927 LAKE RIDGE PKWY STE 148, GRAND PRAIRIE, TX 75052-3087
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
12/19/2021
Last updated
12/19/2021
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