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General NPI Number Information
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NPI Number | 1043541923
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Entity Type | Organization
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Legal Business Name | SAN ANTONIO LABORATORIES INC
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Dates
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Enumeration Date | 01/16/2010
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Last Update Date | 05/01/2010
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Provider Practice Location Address
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Address Line | 211 N LOOP 1604 E STE 201
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City | SAN ANTONIO
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State | TX
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Zip | 78232-1237
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Country | US
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Telephone | 210-247-9691
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Fax | 210-579-1484
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Provider Business Mailing Address
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Address Line | 1777 NE LOOP 410 STE 600
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City | SAN ANTONIO
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State | TX
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Zip | 78217-5209
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Country | US
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Telephone | 210-247-9691
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Fax | 210-579-1484
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHERRY W ABBOUD
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Credential | M.D.
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Telephone | 210-247-9691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 45D0501594
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License Number State | TX
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