Provider Demographics
NPI:1932641115
Name:NATIONWIDE DIAGNOSTICS, LLC
Entity type:Organization
Organization Name:NATIONWIDE DIAGNOSTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWMER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:FASHE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:713-248-1895
Mailing Address - Street 1:2913 LONDON CT
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-4533
Mailing Address - Country:US
Mailing Address - Phone:832-858-3539
Mailing Address - Fax:713-357-7319
Practice Address - Street 1:10021 SOUTH MAIN ST., SUITE B-2B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-5224
Practice Address - Country:US
Practice Address - Phone:713-357-7318
Practice Address - Fax:713-357-7319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-05
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory