Provider Demographics
NPI:1891223806
Name:EMD DIAGNOSTICS LLC
Entity type:Organization
Organization Name:EMD DIAGNOSTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:ADISA
Authorized Official - Last Name:AYOOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-955-3399
Mailing Address - Street 1:19106 E AUSTIN BAYOU CT
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-0014
Mailing Address - Country:US
Mailing Address - Phone:281-955-3399
Mailing Address - Fax:281-955-3372
Practice Address - Street 1:11706 FALLBROOK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-3510
Practice Address - Country:US
Practice Address - Phone:281-955-3399
Practice Address - Fax:281-955-3372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-02
Last Update Date:2017-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX802712961335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier