Healthcare Provider Details

I. General information

NPI: 1467066860
Provider Name (Legal Business Name): PCLTX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2020
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 CYPRESS CREEK PKWY STE 320
HOUSTON TX
77070-5643
US

IV. Provider business mailing address

8300 CYPRESS CREEK PKWY STE 320
HOUSTON TX
77070-5643
US

V. Phone/Fax

Practice location:
  • Phone: 346-374-0007
  • Fax: 346-337-9911
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: ANDREW YEATES
Title or Position: CEO
Credential:
Phone: 346-374-0007