MEDICARE: DEVANSH LAB WERKS,INC

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	:	1760295778
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEVANSH LAB WERKS,INC

Provider Business Mailing Address
First Line	:	6600 PAIGE RD STE 111
Second Line	:
City	:	THE COLONY
State	:	TX
Zip	:	75056-1841
Country	:	US
Telephone Number	:	205-994-8266
Fax Number	:	205-201-4797

Provider Business Practice Location Address
First Line	:	16310 STATE HIGHWAY 249 STE 601
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77064-1346
Country	:	US
Telephone Number	:	205-994-8266
Fax Number	:	205-201-4797

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. SUDHAKAR KANCHARLA
Credential	:
Telephone Number	:	972-757-2695

Provider Enumeration Date	:	01/31/2025
Last Update Date	:	01/31/2025

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