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General NPI Number Information
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NPI Number | 1306989124
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Entity Type | Organization
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Legal Business Name | SONIC LABZONE
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Dates
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Enumeration Date | 02/14/2007
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Last Update Date | 10/08/2008
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Provider Practice Location Address
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Address Line | 8800 W SAM HOUSTON PKWY S SUITE 241
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City | HOUSTON
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State | TX
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Zip | 77099-5208
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Country | US
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Telephone | 281-546-8791
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Fax | 281-914-4399
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Provider Business Mailing Address
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Address Line | 9909 TOPANGA CANYON BLVD SUITE 258
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City | CHATSWORTH
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State | CA
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Zip | 91311-3602
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Country | US
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Telephone | 281-546-8791
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Fax | 281-914-4399
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Authorized Official
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Title or Position | PRESIDENT
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Name | JUSTINO HERRERA ORANTES
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Credential |
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Telephone | 281-546-8791
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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 | 45D1063471
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License Number State | TX
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