MEDICARE: ANGEL AND RIEL ENTERPRISE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1003668849
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANGEL AND RIEL ENTERPRISE LLC

Provider Business Mailing Address
First Line	:	24285 KATY FWY STE 300-137
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-1165
Country	:	US
Telephone Number	:	346-631-3504
Fax Number	:

Provider Business Practice Location Address
First Line	:	24285 KATY FWY STE 300-137
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-1165
Country	:	US
Telephone Number	:	346-631-3504
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	RACHEAL NGOBIDI
Credential	:
Telephone Number	:	281-446-8723

Provider Enumeration Date	:	04/04/2024
Last Update Date	:	04/04/2024

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Directions to “ANGEL AND RIEL ENTERPRISE LLC ” Practice Location

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