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General NPI Number Information
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NPI Number | 1770096158
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Entity Type | Organization
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Legal Business Name | PEAK HLPA, LLC
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Dates
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Enumeration Date | 11/08/2017
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Last Update Date | 12/20/2017
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Provider Practice Location Address
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Address Line | 4315 INDEPENDENCE DR
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City | SCHNECKSVILLE
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State | PA
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Zip | 18078-2587
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Country | US
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Telephone | 972-378-3796
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Fax | 214-594-9760
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Provider Business Mailing Address
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Address Line | 901 HOUSTON ST STE 200
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City | FORT WORTH
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State | TX
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Zip | 76102-6226
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Country | US
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Telephone | 682-350-1031
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MICHAEL ENGLISH
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Credential |
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Telephone | 972-378-3796
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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 | 39D2136329
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License Number State | PA
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