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General NPI Number Information
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NPI Number | 1265746846
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Entity Type | Organization
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Legal Business Name | TEXAS MEDICAL LABORATORY INC
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Dates
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Enumeration Date | 08/05/2010
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Last Update Date | 08/05/2010
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Provider Practice Location Address
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Address Line | 305 RAWLS DR
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City | MCCOMB
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State | MS
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Zip | 39648-2833
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Country | US
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Telephone | 877-781-3393
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Fax |
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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 | 877-781-3391
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | NELLI TOVMASYAN
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Credential |
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Telephone | 877-781-3393
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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 | 25D0320039
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License Number State | MS
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