MEDICARE: REGINA MORGAN PBT (ASCP)

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	246RP1900X	Phlebotomy Technician	28656	IL

General Provider Information

NPI Number	:	1447665120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REGINA MORGAN PBT (ASCP)

Provider Business Mailing Address
First Line	:	507 N BELT DR E
Second Line	:	SUITE 202
City	:	HOUSTON
State	:	TX
Zip	:	77060-4021
Country	:	US
Telephone Number	:	281-928-4841
Fax Number	:	713-965-7506

Provider Business Practice Location Address
First Line	:	507 N BELT DR E
Second Line	:	202
City	:	HOUSTON
State	:	TX
Zip	:	77060-4021
Country	:	US
Telephone Number	:	713-965-7506
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2014
Last Update Date	:	01/20/2017

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