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General NPI Number Information
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NPI Number | 1790848968
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Entity Type | Organization
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Legal Business Name | BERNSTEIN ASSOCIATED MANAGEMENT,LLC
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4315 LOCKWOOD DRIVE
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City | HOUSTON
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State | TX
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Zip | 77026-4117
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Country | US
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Telephone | 713-670-0975
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Fax | 713-670-0998
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Provider Business Mailing Address
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Address Line | 4315 LOCKWOOD DR
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City | HOUSTON
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State | TX
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Zip | 77026-4117
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Country | US
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Telephone | 713-670-0975
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Fax | 713-670-0998
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. BENNIE FERRELL RUCKER
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Credential | PHD
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Telephone | 713-670-0975
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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 | 45DO970553
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License Number State | TX
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