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General NPI Number Information
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NPI Number | 1578833562
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Entity Type | Organization
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Legal Business Name | COMMUNITY MEDICAL LABORATORY
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Dates
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Enumeration Date | 01/06/2012
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Last Update Date | 01/06/2012
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Provider Practice Location Address
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Address Line | 5200 WEST LOOP S 2ND FLOOR,SUITE 204
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City | BELLAIRE
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State | TX
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Zip | 77401-2101
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Country | US
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Telephone | 713-838-8601
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Fax | 713-838-8609
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Provider Business Mailing Address
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Address Line | 5200 WEST LOOP S 2ND FLOOR,SUITE 204
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City | BELLAIRE
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State | TX
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Zip | 77401-2101
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Country | US
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Telephone | 713-838-8601
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Fax | 713-838-8609
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. CLAXTON ORAL ARTHUR
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Credential |
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Telephone | 713-838-8601
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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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