MEDICARE: HARRIS COUNTY PUBLIC HEALTH & ENVIRONMENTAL SERVICES LABORATORY

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		TX

General Provider Information

NPI Number	:	1144375445
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARRIS COUNTY PUBLIC HEALTH & ENVIRONMENTAL SERVICES LABORATORY

Provider Business Mailing Address
First Line	:	3330 OLD SPANISH TRL
Second Line	:	SUITE 103
City	:	HOUSTON
State	:	TX
Zip	:	77021-2268
Country	:	US
Telephone Number	:	713-440-3051
Fax Number	:

Provider Business Practice Location Address
First Line	:	3330 OLD SPANISH TRL
Second Line	:	SUITE 103
City	:	HOUSTON
State	:	TX
Zip	:	77021-2268
Country	:	US
Telephone Number	:	713-440-3051
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	HERMANIA PALACIO
Credential	:	MD
Telephone Number	:	713-439-6000

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	08/22/2020

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