Provider Demographics
NPI:1376360511
Name:BDXTX INC
Entity type:Organization
Organization Name:BDXTX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KOGELNIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-776-4703
Mailing Address - Street 1:10300 N CENTRAL EXPY STE 250
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-8662
Mailing Address - Country:US
Mailing Address - Phone:650-776-4703
Mailing Address - Fax:
Practice Address - Street 1:10300 N CENTRAL EXPY STE 250
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-8662
Practice Address - Country:US
Practice Address - Phone:650-776-4703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory