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NPI Code Detail

MEDICARE: ST MICHAELS LABS INC

MEDICARE: ST MICHAELS LABS INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1291U00000XClinical Medical Laboratory45D1044582TX

General Provider Information

NPI Number : 1679697387
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST MICHAELS LABS INC
Provider Business Mailing Address
First Line : PO BOX 924587
Second Line :
City : HOUSTON
State : TX
Zip : 77292-4587
Country : US
Telephone Number : 713-812-1612
Fax Number :
Provider Business Practice Location Address
First Line : 3726 DACOMA ST
Second Line :
City : HOUSTON
State : TX
Zip : 77092-8906
Country : US
Telephone Number : 713-812-1612
Fax Number :
Authorized Official
Title or Position : LABORATORY DIRECTOR
Name : DR. RANDOLPH A LOPEZ
Credential : M.D.,
Telephone Number : 713-812-1612
Provider Enumeration Date : 03/19/2007
Last Update Date : 10/30/2008

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Directions to “ST MICHAELS LABS INC ” Practice Location

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