Healthcare Provider Details

I. General information

NPI: 1528031481
Provider Name (Legal Business Name): DIAGNOSTIC CLINIC OF HOUSTON LAB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 BINZ ST SUITE 300
HOUSTON TX
77004-6900
US

IV. Provider business mailing address

1200 BINZ ST SUITE 300
HOUSTON TX
77004-6900
US

V. Phone/Fax

Practice location:
  • Phone: 713-797-9191
  • Fax: 713-394-2852
Mailing address:
  • Phone: 713-797-9191
  • Fax: 713-394-2852

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: DORMA L KOHLER
Title or Position: CEO
Credential:
Phone: 713-797-9191