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General NPI Number Information
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NPI Number | 1841524907
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Entity Type | Organization
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Legal Business Name | BIOTECH CLINICAL ANALYSTS
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Dates
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Enumeration Date | 09/22/2009
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Last Update Date | 09/22/2009
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Provider Practice Location Address
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Address Line | 1116 BREVITO DR STE. B
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City | GRAND PRAIRIE
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State | TX
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Zip | 75052-7124
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Country | US
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Telephone | 888-737-7559
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Fax | 866-362-0116
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Provider Business Mailing Address
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Address Line | 1116 BREVITO DR STE. B
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City | GRAND PRAIRIE
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State | TX
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Zip | 75052-7124
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Country | US
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Telephone | 888-737-7559
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Fax | 866-362-0116
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Authorized Official
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Title or Position | OWNER/LAB DIRECTOR
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Name | MS. BEDAR STEPHANE DOYLE
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Credential | MT/HEW/USAR
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Telephone | 214-650-6161
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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 | 21645
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License Number State | TX
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