Provider Demographics
NPI:1992319818
Name:AMERICA'S MEDICAL DIAGNOSTICS CENTER- AMDXC-LLC
Entity type:Organization
Organization Name:AMERICA'S MEDICAL DIAGNOSTICS CENTER- AMDXC-LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-303-9215
Mailing Address - Street 1:6090 SURETY DR STE 420
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-2057
Mailing Address - Country:US
Mailing Address - Phone:915-303-9215
Mailing Address - Fax:915-218-6518
Practice Address - Street 1:6090 SURETY DR STE 420
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2057
Practice Address - Country:US
Practice Address - Phone:915-303-9215
Practice Address - Fax:915-303-9216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-08
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty
No246QL0900XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyLaboratory ManagementGroup - Multi-Specialty
No291U00000XLaboratoriesClinical Medical Laboratory