Provider Demographics
NPI:1922210913
Name:COMPLETE PULMONARY DIAGNOSTIC SERVICES, INC.
Entity type:Organization
Organization Name:COMPLETE PULMONARY DIAGNOSTIC SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:RRT, RPFT, AE-C
Authorized Official - Phone:512-554-6683
Mailing Address - Street 1:1731 WESTMINSTER WAY
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613
Mailing Address - Country:US
Mailing Address - Phone:512-554-6683
Mailing Address - Fax:512-260-7213
Practice Address - Street 1:2300 LOHMANS SPUR
Practice Address - Street 2:SUITE 104
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78734-6206
Practice Address - Country:US
Practice Address - Phone:512-554-6683
Practice Address - Fax:512-260-7213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX671152279P1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2279P1006XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary Function TechnologistGroup - Single Specialty