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General NPI Number Information
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NPI Number | 1790524577
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Entity Type | Organization
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Legal Business Name | GULF SOUTH DIAGNOSTIC SOLUTIONS LLC
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Dates
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Enumeration Date | 05/22/2024
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 2500 SUMMER ST
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City | HOUSTON
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State | TX
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Zip | 77007-3826
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Country | US
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Telephone | 504-827-1050
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Fax |
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Provider Business Mailing Address
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Address Line | 579 WOODVINE AVE
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City | METAIRIE
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State | LA
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Zip | 70005-4443
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | CHRISTOPHER RIDGEWAY
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Credential |
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Telephone | 713-299-6466
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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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