MYCODART INC (NPI# 1023653623) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023653623 |
| Entity Type | Organization |
| Organization Name | MYCODART INC |
| Practice Address |
4100 Fairway Dr Ste 640 Carrollton TX 75010-6525 |
| Practice Telephone | 9724920419 |
| Practice Fax Number | 9722437759 |
| Mailing Telephone | 9724920419 |
| Mailing Fax Number | 9722437759 |
| Enumeration Date | 2019-11-07 |
| Last Update Date | 2019-11-07 |
| Authorized Official Name | MR. JEFFREY HOOPER (CFO) |
| Authorized Official Telephone | 9724920419 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CLIA | 45D2158080 | 01 |
| Street Address |
4100 FAIRWAY DR STE 640 |
| City | CARROLLTON |
| State | TX |
| Zip Code | 75010-6525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043782907 | Timothy C. Pringle Md Pa | Surgery | 4541 N. Josey Lane, Suite 140, Carrollton, TX 75010 | 2018-12-17 |
| 1184106411 | Cindy T Vu | Occupational Therapy Assistant | 1877 Cheyenne, Carrollton, TX 75010 | 2018-09-04 |
| 1639686256 | Little Lantern Hospice LLC | Hospice Care, Community Based | 4541 North Josey Lane, Suite 110-b, Carrollton, TX 75010 | 2018-01-04 |
| 1235681610 | Kahini Shah | Physical Therapist | 1012 W Hebron Pkwy Ste 124, Carrollton, TX 75010 | 2016-11-01 |
| 1881148849 | Wais Azesh | Dentist | 1233 Apache Lake Dr, Carrollton, TX 75010 | 2016-08-08 |
| 1225485055 | Julia Buckelew | Physical Therapist | 4100 Fairway Dr Ste 400, Carrollton, TX 75010 | 2016-05-23 |
| 1811355639 | Fastpass Ucc, Pllc | Clinic/Center | 4228 N Josey Ln Ste 150, Carrollton, TX 75010 | 2016-02-08 |
| 1326404393 | Miaojuan Li | Nurse Practitioner | 4100 Fairway Dr Ste 300, Carrollton, TX 75010 | 2016-01-06 |
| 1912376112 | Envoy Hospice North LLC | Hospice Care, Community Based | 4040 Tx-121, Carrollton, TX 75010 | 2015-09-17 |
| 1932593936 | Lifeway Hospice, LLC | Hospice Care, Community Based | 4040 State Highway 121, Suite 140, Carrollton, TX 75010 | 2015-03-27 |
| Find all providers in zip 75010 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639777899 | White Coat Sciences LLC | Clinical Medical Laboratory | 315 Bankhead Hwy Ste A, Carrollton, GA 30117-2487 | 2020-10-11 |
| 1417574666 | Devlab | Clinical Medical Laboratory | 4100 Fairway Dr Ste 100, Carrollton, TX 75010-6526 | 2020-07-02 |
| 1609316132 | Abs Labs LLC | Clinical Medical Laboratory | 1600 Wallace Dr, Suite 110, Carrollton, TX 75006-8006 | 2017-03-02 |
| 1952843294 | Star Labs | Clinical Medical Laboratory | 1735 Keller Springs Rd Ste 208, Carrollton, TX 75006-3015 | 2016-11-16 |
| 1689025116 | New Schryver LLC | Clinical Medical Laboratory | 3414 Midcourt Rd Ste 112, Carrollton, TX 75006-5092 | 2016-06-27 |
| 1407206303 | Bds Healthcare, LLC | Clinical Medical Laboratory | 1321 Valwood Pkwy Ste 660, Carrollton, TX 75006-6889 | 2016-06-21 |
| 1114306636 | Lighthouse Labs LLC | Clinical Medical Laboratory | 1735 Keller Springs Rd Ste 202, Carrollton, TX 75006-3006 | 2015-05-29 |
| 1316326838 | Reliable Labs LLC | Clinical Medical Laboratory | 1735 Keller Springs Rd Ste 210b, Carrollton, TX 75006-3014 | 2015-05-29 |
| 1720498876 | Lotus Labs | Clinical Medical Laboratory | 1735 Keller Springs Rd Ste 210, Carrollton, TX 75006-3014 | 2014-04-29 |
| 1407273444 | Dmm Lab LLC | Clinical Medical Laboratory | 1521 Mapleview Dr, Carrollton, TX 75007-6019 | 2014-03-27 |
| Find all providers in CARROLLTON | ||||
| City | CARROLLTON |
| Zip Code | 75010 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.