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General NPI Number Information
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NPI Number | 1093017840
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Entity Type | Organization
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Legal Business Name | CENTURY PATHOLOGY, LLC
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Dates
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Enumeration Date | 11/30/2010
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Last Update Date | 11/30/2010
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Provider Practice Location Address
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Address Line | 9150 S MAIN ST
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City | HOUSTON
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State | TX
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Zip | 77025-3843
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Country | US
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Telephone | 713-589-6879
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Fax |
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Provider Business Mailing Address
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Address Line | 1415 NORTH LOOP W SUITE 1200
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City | HOUSTON
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State | TX
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Zip | 77008-1664
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Country | US
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Telephone | 713-589-6879
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Fax | 713-795-5081
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Authorized Official
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Title or Position | REVENUE MANAGER
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Name | CYNTHIA DAVIS
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Credential |
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Telephone | 713-589-6879
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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 | K9353
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License Number State | TX
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