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General NPI Number Information
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NPI Number | 1316555204
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Entity Type | Organization
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Legal Business Name | IMMUNOGENOMICS LLC
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Dates
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Enumeration Date | 07/17/2020
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Last Update Date | 01/27/2026
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Provider Practice Location Address
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Address Line | 202 INDUSTRIAL BLVD STE 501
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City | SUGAR LAND
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State | TX
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Zip | 77478-2702
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Country | US
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Telephone | 832-500-4462
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Fax | 210-750-1245
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Provider Business Mailing Address
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Address Line | 202 INDUSTRIAL BLVD STE 501
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City | SUGAR LAND
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State | TX
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Zip | 77478-2702
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Country | US
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Telephone | 832-500-4462
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Fax | 210-750-1245
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | TWINKLE PATEL
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Credential | MSC
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Telephone | 850-849-2554
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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 |
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License Number State |
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