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General NPI Number Information
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NPI Number | 1316976178
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Entity Type | Organization
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Legal Business Name | ORDERED STEP PROFESSIONAL GROUP
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Dates
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Enumeration Date | 07/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3507 HORNE STREET
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City | FORT WORTH
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State | TX
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Zip | 76107-6603
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Country | US
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Telephone | 817-732-3062
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Fax | 817-732-3529
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Provider Business Mailing Address
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Address Line | 3507 HORNE ST
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City | FORT WORTH
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State | TX
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Zip | 76107-6603
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Country | US
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Telephone | 817-732-3062
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Fax | 817-732-3529
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Authorized Official
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Title or Position | CEO
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Name | MRS. MAEIDA YVETTE OWUSU-ANSAH
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Credential |
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Telephone | 817-732-3062
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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 | TX
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