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General NPI Number Information
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NPI Number | 1992390959
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Entity Type | Organization
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Legal Business Name | BIOEXCEL DIAGNOSTICS
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Dates
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Enumeration Date | 03/02/2021
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Last Update Date | 07/14/2021
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Provider Practice Location Address
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Address Line | 2636 S LOOP W STE 110
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City | HOUSTON
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State | TX
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Zip | 77054-2680
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Country | US
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Telephone | 832-425-5042
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Fax |
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Provider Business Mailing Address
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Address Line | 2636 S LOOP W STE 110
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City | HOUSTON
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State | TX
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Zip | 77054-2680
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Country | US
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Telephone | 832-425-5042
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Fax |
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Authorized Official
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Title or Position | LAB DIRECTOR
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Name | DR. MEHDI DEHGHANI
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Credential | PH.D.
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Telephone | 832-425-5042
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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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