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NPI Code Detail

MEDICARE: OH-LABS LLC

MEDICARE: OH-LABS 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
1207L00000XAnesthesiology PhysicianG51360CA

General Provider Information

NPI Number : 1336300060
Entity Type Code : Organization
Provider Name (Legal Business Name) : OH-LABS LLC
Provider Business Mailing Address
First Line : PO BOX 191089
Second Line : 123
City : DALLAS
State : TX
Zip : 75219-8089
Country : US
Telephone Number : 214-717-4683
Fax Number :
Provider Business Practice Location Address
First Line : 3521 OAK LAWN AVE
Second Line : 123
City : DALLAS
State : TX
Zip : 75219-4309
Country : US
Telephone Number : 214-717-4683
Fax Number : 484-970-6356
Authorized Official
Title or Position : CHIEF MEDICAL OFFICER
Name : DR. DARREN F CLAIR
Credential : MD
Telephone Number : 310-275-4884
Provider Enumeration Date : 06/25/2008
Last Update Date : 06/25/2008

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Directions to “OH-LABS LLC ” Practice Location

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