Provider Demographics
NPI:1003247198
Name:SOUTH TEXAS REGIONAL LABORATORIES INC
Entity Type:Organization
Organization Name:SOUTH TEXAS REGIONAL LABORATORIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEOPOLDO
Authorized Official - Middle Name:SERGIO
Authorized Official - Last Name:COBOS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, MT(ASCP)
Authorized Official - Phone:210-371-7888
Mailing Address - Street 1:PO BOX 1628
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78853-1628
Mailing Address - Country:US
Mailing Address - Phone:210-371-7888
Mailing Address - Fax:210-399-0761
Practice Address - Street 1:1975 N VETERANS BLVD
Practice Address - Street 2:SUITE 5
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-6114
Practice Address - Country:US
Practice Address - Phone:210-371-7888
Practice Address - Fax:210-399-0761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-28
Last Update Date:2015-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45D0938565291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory