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General NPI Number Information
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NPI Number | 1346592565
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Entity Type | Organization
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Legal Business Name | PREMIER TOXICOLOGY, PLLC
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Dates
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Enumeration Date | 10/11/2012
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Last Update Date | 10/11/2012
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Provider Practice Location Address
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Address Line | 1000 JOHNSON ST SUITE 1
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City | DENTON
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State | TX
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Zip | 76205-1210
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Country | US
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Telephone | 214-985-2624
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 JOHNSON ST SUITE 1
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City | DENTON
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State | TX
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Zip | 76205-1210
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPERATIONS MANAGER
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Name | JOHN H. DIXON III
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Credential |
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Telephone | 214-985-2624
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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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