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General NPI Number Information
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NPI Number | 1497001234
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Entity Type | Organization
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Legal Business Name | ROBIN JOHNSON
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Dates
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Enumeration Date | 07/30/2012
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Last Update Date | 08/30/2013
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Provider Practice Location Address
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Address Line | 7901 CAMERON RD BLDG 3 SUITE 326
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City | AUSTIN
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State | TX
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Zip | 78754-3831
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Country | US
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Telephone | 512-906-5507
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Fax | 512-334-9900
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Provider Business Mailing Address
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Address Line | 1515 KELLETT AVE
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City | SCHULENBURG
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State | TX
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Zip | 78956-2251
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Country | US
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Telephone | 512-906-5507
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Fax | 512-334-9900
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Authorized Official
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Title or Position | LABORATORY DIRECTOR
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Name | MRS. ROBIN JOHNSON
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Credential |
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Telephone | 512-906-5507
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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 | 45D2043244
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License Number State | TX
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