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General NPI Number Information
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NPI Number | 1063911220
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Entity Type | Organization
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Legal Business Name | EXCELSIOR DIAGNOSTICS LLC
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Dates
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Enumeration Date | 02/02/2018
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Last Update Date | 09/09/2020
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Provider Practice Location Address
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Address Line | 9800 CENTRE PKWY STE 200
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City | HOUSTON
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State | TX
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Zip | 77036-8264
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Country | US
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Telephone | 713-571-4270
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Fax |
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Provider Business Mailing Address
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Address Line | 12605 EAST FWY STE 365
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City | HOUSTON
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State | TX
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Zip | 77015-5625
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MR. YOSSI SCHWARZ
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Credential |
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Telephone | 713-571-4270
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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 |
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License Number State |
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