Provider Demographics
NPI:1215809413
Name:MEDIWELL LAB CORPORATION
Entity type:Organization
Organization Name:MEDIWELL LAB CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PIYUSH ARUN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:945-342-8624
Mailing Address - Street 1:5005 W ROYAL LN STE 250
Mailing Address - Street 2:250
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-1961
Mailing Address - Country:US
Mailing Address - Phone:945-221-7760
Mailing Address - Fax:945-262-6051
Practice Address - Street 1:5005 W ROYAL LN STE 250
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-1961
Practice Address - Country:US
Practice Address - Phone:945-342-8624
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-18
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory