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General NPI Number Information
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NPI Number | 1437296175
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Entity Type | Organization
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Legal Business Name | WILKENFELD MEDICAL LABORATORIES, I, LTD.
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 07/12/2007
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Provider Practice Location Address
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Address Line | 8830 LONG POINT RD SUITE 104
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City | HOUSTON
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State | TX
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Zip | 77055-3040
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Country | US
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Telephone | 713-464-5326
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 800967
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City | HOUSTON
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State | TX
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Zip | 77280-0967
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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 | LABORATORY MANAGER
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Name | DR. JEROME STANLEY WILKENFELD
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Credential | M.D.
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Telephone | 713-468-0738
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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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