MEDICARE: THRIVE MEDICAL 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

General Provider Information

NPI Number	:	1427911957
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THRIVE MEDICAL LABORATORY

Provider Business Mailing Address
First Line	:	6111 FM 1960 RD W
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77069-4112
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6111 FM 1960 RD W
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77069-4112
Country	:	US
Telephone Number	:	980-277-1579
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	BENJAMIN WILLIAMSON
Credential	:
Telephone Number	:	239-944-0249

Provider Enumeration Date	:	12/03/2025
Last Update Date	:	06/09/2026

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Directions to “THRIVE MEDICAL LABORATORY ” Practice Location

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