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General NPI Number Information
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NPI Number | 1346513678
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Entity Type | Organization
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Legal Business Name | DERMOPATH LABORATORIES, L.L.C.
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Dates
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Enumeration Date | 02/16/2012
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Last Update Date | 06/25/2015
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Provider Practice Location Address
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Address Line | 1501 BROADWAY ST SUITE C
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City | GALVESTON
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State | TX
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Zip | 77550-4906
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Country | US
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Telephone | 409-621-5094
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Fax | 409-621-5132
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Provider Business Mailing Address
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Address Line | 1501 BROADWAY ST SUITE C
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City | GALVESTON
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State | TX
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Zip | 77550-4906
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Country | US
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Telephone | 409-621-5094
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Fax | 409-621-5132
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. RAMON L. SANCHEZ
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Credential | M.D.
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Telephone | 409-621-5094
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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 | 45D0950289
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License Number State | TX
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