=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881515898
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SOFT CELL LABS TX, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/24/2026
-----------------------------------------------------
Last Update Date | 07/24/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4125 FAIRWAY DR STE 135
-----------------------------------------------------
City | CARROLLTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75010-6510
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-402-2505
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1915 NE STUCKI AVE STE 100
-----------------------------------------------------
City | HILLSBORO
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97006-6951
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-402-2504
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | ROEL CHAVEZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 971-570-4008
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 291U00000X
-----------------------------------------------------
Taxonomy Name | Clinical Medical Laboratory
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------