| NPI | 1518350040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRABHAV K TELLA Administrator 972-607-9980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: TX 45D2090337) |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2015-03-20 |