Basic Information
| Provider Information | |||||||||
| NPI: | 1508172909 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NUEPATH1, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11221 ROE AVE STE 300 | ||||||||
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| City: | LEAWOOD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662111941 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9133870510 | ||||||||
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| Practice Location | |||||||||
| Address1: | 8340 STERLING ST | ||||||||
| Address2: | SUITE 1 | ||||||||
| City: | IRVING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750632593 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9133870661 | ||||||||
| FaxNumber: | 9133870861 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2010 | ||||||||
| LastUpdateDate: | 12/20/2017 | ||||||||
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| AuthorizedOfficialLastName: | TASSET | ||||||||
| AuthorizedOfficialFirstName: | DANIEL | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT, NUETERRA | ||||||||
| AuthorizedOfficialTelephone: | 9133870510 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 291U00000X | Y | Laboratories | Clinical Medical Laboratory |
No ID Information.