| Northwest Diagnostic Clinic | |
|
500 W Whitestone Blvd Suite 100 Cedar Park TX 78613-2245 | |
| (512) 250-3900 | |
| (512) 249-6232 |
| Full Name | Northwest Diagnostic Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 500 W Whitestone Blvd, Cedar Park, Texas |
| Authorized Official Name and Position | Michael Bruce Bogdanovich (PRESIDENT) |
| Authorized Official Contact | 5122503900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Diagnostic Clinic 500 W Whitestone Blvd Suite 100 Cedar Park TX 78613-2245 Ph: (512) 250-3900 | Northwest Diagnostic Clinic 500 W Whitestone Blvd Suite 100 Cedar Park TX 78613-2245 Ph: (512) 250-3900 |
| NPI Number | 1780612390 |
|---|---|
| Provider Enumeration Date | 06/30/2006 |
| Last Update Date | 01/04/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780612390 | NPI | - | NPPES |
| 00769N | Other | TX | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | H6779 (Texas) | Primary |
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