=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912889585
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BHS PHYSICIANS LAB
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/23/2025
-----------------------------------------------------
Last Update Date | 07/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13603 MICHEL RD STE 200A
-----------------------------------------------------
City | TOMBALL
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77375-6410
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-730-9269
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5554 S PEEK RD STE 2104
-----------------------------------------------------
City | KATY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77450-7130
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-730-9269
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | STEVEN WINES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 713-820-3900
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 291U00000X
-----------------------------------------------------
Taxonomy Name | Clinical Medical Laboratory
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------