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General NPI Number Information
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NPI Number | 1568868446
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Entity Type | Organization
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Legal Business Name | DTR LABS LLC
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Dates
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Enumeration Date | 11/05/2014
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Last Update Date | 12/04/2019
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Provider Practice Location Address
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Address Line | 2150 JUSTIN RD STE. 300
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City | HIGHLAND VILLAGE
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State | TX
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Zip | 75077-7163
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Country | US
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Telephone | 866-387-5227
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Fax | 469-702-6037
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Provider Business Mailing Address
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Address Line | 2150 JUSTIN RD STE. 300
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City | HIGHLAND VILLAGE
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State | TX
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Zip | 75077-7163
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Country | US
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Telephone | 469-702-6015
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Fax | 469-702-6037
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | BLAKE LARKIN TRIMBLE
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Credential |
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Telephone | 817-901-8144
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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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