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General NPI Number Information
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NPI Number | 1891796256
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Entity Type | Organization
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Legal Business Name | DOCTORS GENERAL LABORATORY
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Dates
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Enumeration Date | 08/09/2005
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Last Update Date | 05/22/2013
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Provider Practice Location Address
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Address Line | 12501 HYMEADOW DR SUITE 2B
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City | AUSTIN
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State | TX
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Zip | 78750-2263
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Country | US
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Telephone | 512-996-0900
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Fax | 512-692-4596
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Provider Business Mailing Address
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Address Line | 12501 HYMEADOW DR SUITE 2B
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City | AUSTIN
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State | TX
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Zip | 78750-2263
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Country | US
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Telephone | 512-996-0900
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Fax | 512-692-4596
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Authorized Official
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Title or Position | C.E.O.
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Name | MR. DAVID S WEINER
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Credential |
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Telephone | 512-996-0900
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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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Taxonomy #2
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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