Provider Demographics
NPI:1225372550
Name:ACCURATE DIAGNOSTIC MGT SVCS INC
Entity type:Organization
Organization Name:ACCURATE DIAGNOSTIC MGT SVCS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:SIDDIQUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-972-8151
Mailing Address - Street 1:PO BOX 297
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019
Mailing Address - Country:US
Mailing Address - Phone:702-530-7492
Mailing Address - Fax:877-705-3046
Practice Address - Street 1:2781 ITHACA PLACE
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067
Practice Address - Country:US
Practice Address - Phone:702-530-7492
Practice Address - Fax:877-705-3046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-27
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME942182084N0400X, 2084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Single Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL30990ZOtherMEDICARE ID-TYPE UNSPECIFIED. FL
FL30990ZOtherMEDICARE ID-TYPE UNSPECIFIED. FL