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General NPI Number Information
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NPI Number | 1528204732
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Entity Type | Organization
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Legal Business Name | METROSTAT DIAGNOSTIC SERVICES, INC.
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Dates
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Enumeration Date | 12/18/2008
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Last Update Date | 12/18/2008
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Provider Practice Location Address
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Address Line | 325 GOLD ST 120
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City | GARLAND
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State | TX
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Zip | 75042-6658
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Country | US
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Telephone | 972-205-1144
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Fax | 972-205-1115
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Provider Business Mailing Address
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Address Line | 325 GOLD ST 120
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City | GARLAND
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State | TX
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Zip | 75042-6658
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Country | US
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Telephone | 972-205-1144
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Fax | 972-205-1115
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. JEFFREY EARL FELTS
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Credential |
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Telephone | 972-205-1144
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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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