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General NPI Number Information
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NPI Number | 1669463451
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Entity Type | Organization
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Legal Business Name | DSHS GENETIC SERVICES
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Dates
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Enumeration Date | 11/02/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 401 E FRANKLIN AVE SUITE 210
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City | EL PASO
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State | TX
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Zip | 79901-1206
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Country | US
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Telephone | 915-834-7745
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Fax | 915-834-7804
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Provider Business Mailing Address
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Address Line | 1100 W 49TH ST ROOM M-555, MC 1918
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City | AUSTIN
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State | TX
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Zip | 78756-3101
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Country | US
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Telephone | 512-458-7111
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Fax | 512-458-7593
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Authorized Official
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Title or Position | CLINICAL GENETICIST
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Name | DR. LESLEY MARGARET DRUMMOND-BORG
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Credential | MD
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Telephone | 512-458-7111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 170100000X
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Taxonomy Name | Ph.D. Medical Genetics
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License Number |
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License Number State |
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