Provider Demographics
NPI:1053417881
Name:DISCOVERY DIAGNOSTICS, LLC
Entity type:Organization
Organization Name:DISCOVERY DIAGNOSTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTES
Authorized Official - Suffix:
Authorized Official - Credentials:REEGT; RNCST
Authorized Official - Phone:972-998-1548
Mailing Address - Street 1:506 SAGE CT
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-3183
Mailing Address - Country:US
Mailing Address - Phone:972-998-1548
Mailing Address - Fax:972-899-2375
Practice Address - Street 1:506 SAGE CT
Practice Address - Street 2:
Practice Address - City:HIGHLAND VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75077-3183
Practice Address - Country:US
Practice Address - Phone:972-998-1548
Practice Address - Fax:972-899-2375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes293D00000XLaboratoriesPhysiological Laboratory
No246ZE0500XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherEEGGroup - Multi-Specialty
No246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnosticGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1920282Medicaid
TXP00474218OtherPALMETTO GBA MEDICARE RAILROAD CARRIER
TXP00474218OtherPALMETTO GBA MEDICARE RAILROAD CARRIER