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General NPI Number Information
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NPI Number | 1316702822
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Entity Type | Organization
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Legal Business Name | HOUSTON DNA LAB CENTER, LLC
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Dates
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Enumeration Date | 02/14/2024
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Last Update Date | 03/28/2024
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Provider Practice Location Address
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Address Line | 1022 PASADENA BLVD STE D
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City | PASADENA
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State | TX
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Zip | 77506-4764
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Country | US
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Telephone | 713-329-8655
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Fax | 713-429-8656
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Provider Business Mailing Address
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Address Line | 1022 PASADENA BLVD STE D
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City | PASADENA
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State | TX
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Zip | 77506-4764
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Country | US
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Telephone | 713-429-8655
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Fax | 713-429-8656
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | VALONDRA NIMROD
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Credential |
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Telephone | 713-429-8655
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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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