Provider Demographics
NPI:1073898748
Name:ADVANCED TOXICOLOGY
Entity Type:Organization
Organization Name:ADVANCED TOXICOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-442-1028
Mailing Address - Street 1:1000 JOHNSON ST STE 3
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-1211
Mailing Address - Country:US
Mailing Address - Phone:940-239-8806
Mailing Address - Fax:
Practice Address - Street 1:1000 JOHNSON ST STE 3
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-1211
Practice Address - Country:US
Practice Address - Phone:940-239-8806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6117291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory