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General NPI Number Information
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NPI Number | 1194485870
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Entity Type | Organization
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Legal Business Name | KHEM LABS LLC
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Dates
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Enumeration Date | 12/22/2021
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Last Update Date | 07/15/2022
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Provider Practice Location Address
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Address Line | 2411 WILLIAMS DR STE 3
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City | GEORGETOWN
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State | TX
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Zip | 78628-3261
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Country | US
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Telephone | 512-661-8521
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Fax | 512-820-1244
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Provider Business Mailing Address
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Address Line | 6701 ZENITH CV
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City | AUSTIN
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State | TX
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Zip | 78759-4695
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Country | US
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Telephone | 512-661-8521
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Fax | 512-820-1244
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Authorized Official
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Title or Position | OWNER/AUTHORIZED OFFICIAL
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Name | KUNAL NAGARSHETH
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Credential | PHARMD
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Telephone | 832-687-7167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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