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General NPI Number Information
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NPI Number | 1275876591
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Entity Type | Organization
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Legal Business Name | DAVINCI INNOVATIONS, LLC
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Dates
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Enumeration Date | 04/04/2013
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Last Update Date | 03/04/2014
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Provider Practice Location Address
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Address Line | 9150 MAIN ST SUITE C
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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 | 844-384-5887
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Fax | 807-270-7384
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Provider Business Mailing Address
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Address Line | PO BOX 847090
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City | BOSTON
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State | MA
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Zip | 02284-7090
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Country | US
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Telephone | 844-384-5887
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Fax | 807-270-7384
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Authorized Official
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Title or Position | CEO
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Name | MRS. LAURA ANN MILLER
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Credential |
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Telephone | 518-598-7272
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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 | L13000030595
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License Number State | FL
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