Independent Mobil Diagnostice Testing Facility

LBN: Independent Mobil Diagnostice Testing Facility
Independent Mobil Diagnostice Testing Facility is an health care organization with primary practice located at 1661 Woodard Ave Suite 110, Cleburne TX 76033-7052. The organization recently has 2 registered licenses in different health care specialties including Managed Care Organizations / Preferred Provider Organization, Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities. Managed Care Organizations / Preferred Provider Organization is the primary health care specialty. Independent Mobil Diagnostice Testing Facility can be contacted via phone (817) 494-6875, or through Maxon, Edmond S via phone (817) 494-6875.

Contact Information

Primary practice address
1661 Woodard Ave Suite 110 Cleburne TX 76033-7052
Phone: (817) 494-6875
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Maxon, Edmond S LBSW
Phone: (817) 494-6875

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Preferred Provider Organization 305R00000X 22799 Texas
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X 22799 Texas

Profile Details

NPI number 1437434206
LBN Legal business name Independent Mobil Diagnostice Testing Facility
DBA Doing business as
Authorized official Maxon, Edmond S LBSW
Entity Organization
Organization subpart 1 No
Enumeration date Oct 12th, 2011
Last updated Oct 12th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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