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General NPI Number Information
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NPI Number | 1679744098
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Entity Type | Organization
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Legal Business Name | BCM CLINIC LAB
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Dates
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Enumeration Date | 03/13/2008
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Last Update Date | 03/13/2008
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Provider Practice Location Address
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Address Line | 6620 MAIN ST SUITE 11D.23
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City | HOUSTON
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State | TX
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Zip | 77030-2348
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Country | US
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Telephone | 713-798-2313
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Fax |
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Provider Business Mailing Address
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Address Line | 6620 MAIN ST SUITE 1275
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City | HOUSTON
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State | TX
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Zip | 77030-2348
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Country | US
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Telephone | 713-798-2313
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. SONJA BEATY
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Credential |
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Telephone | 713-798-1127
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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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