| NPI | 1639041759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIAN BOUTALOTH Owner 817-801-7300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 247ZC0005X Pathology, Clinical Laboratory Director, Non-physician |
| Enumeration Date | 2025-09-18 |
| Last Update Date | 2025-12-24 |