Healthcare Provider Details

I. General information

NPI: 1255089025
Provider Name (Legal Business Name): H.B. PHLEBOTOMY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2022
Last Update Date: 03/11/2022
Certification Date: 03/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1511 LINDENWOOD DR
ORANGE TX
77630-2811
US

IV. Provider business mailing address

1511 LINDENWOOD DR
ORANGE TX
77630-2811
US

V. Phone/Fax

Practice location:
  • Phone: 512-294-4390
  • Fax:
Mailing address:
  • Phone: 512-294-4390
  • 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: WILLIE GEORGE HAINS JR.
Title or Position: OWNER
Credential:
Phone: 512-294-4390