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General NPI Number Information
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NPI Number | 1063707743
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Entity Type | Organization
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Legal Business Name | UNITED TOXICOLOGY,LLC
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Dates
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Enumeration Date | 06/10/2011
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Last Update Date | 05/15/2014
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Provider Practice Location Address
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Address Line | 5710 LBJ FREEWAY 215
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City | DALLAS
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State | TX
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Zip | 75240-6398
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Country | US
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Telephone | 972-432-6551
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Fax | 214-276-1359
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Provider Business Mailing Address
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Address Line | 5710 LBJ FREEWAY 325
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City | DALLAS
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State | TX
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Zip | 75240
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Country | US
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Telephone | 972-432-6551
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Fax | 214-276-1359
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Authorized Official
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Title or Position | CEO
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Name | MR. JOSH DANIEL
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Credential |
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Telephone | 972-432-6551
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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 | 45D2023963
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License Number State | TX
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