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General NPI Number Information
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NPI Number | 1609592450
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Entity Type | Organization
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Legal Business Name | ADG HOUSTON PATH PLLC
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Dates
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Enumeration Date | 10/13/2022
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Last Update Date | 10/13/2022
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Provider Practice Location Address
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Address Line | 2525 W BELLFORT AVE STE 194
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City | HOUSTON
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State | TX
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Zip | 77054-5099
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Country | US
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Telephone | 346-231-1151
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Fax | 281-661-7569
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Provider Business Mailing Address
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Address Line | 2525 W BELLFORT AVE STE 194
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City | HOUSTON
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State | TX
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Zip | 77054-5099
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Country | US
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Telephone | 346-231-1151
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Fax | 281-661-7569
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Authorized Official
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Title or Position | PRESIDENT
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Name | JARYD STEIN
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Credential | MD
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Telephone | 213-392-4976
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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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