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General NPI Number Information
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NPI Number | 1558717827
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Entity Type | Organization
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Legal Business Name | CONCORD LIFE SCIENCES, LLC
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Dates
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Enumeration Date | 05/05/2016
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 16840 BUCCANEER LN STE 281
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City | HOUSTON
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State | TX
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Zip | 77058-2562
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Country | US
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Telephone | 888-932-0990
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Fax | 281-949-8599
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Provider Business Mailing Address
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Address Line | 2437 BAY AREA BLVD # 504
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City | HOUSTON
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State | TX
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Zip | 77058-1519
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Country | US
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Telephone | 888-932-0990
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Fax | 281-949-8599
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Authorized Official
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Title or Position | CFO
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Name | CHRISTOPHER LIGHT
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Credential |
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Telephone | 800-837-8160
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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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