Provider Demographics
NPI:1114205580
Name:SPIRO STAT TECHNOLOGIES, L.P.
Entity Type:Organization
Organization Name:SPIRO STAT TECHNOLOGIES, L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BOOTHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-885-2929
Mailing Address - Street 1:1004 GARFIELD DR
Mailing Address - Street 2:BLDG 340
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79416-2118
Mailing Address - Country:US
Mailing Address - Phone:806-885-2929
Mailing Address - Fax:806-885-2933
Practice Address - Street 1:1004 GARFIELD DR
Practice Address - Street 2:BLDG 340
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79416-2118
Practice Address - Country:US
Practice Address - Phone:806-885-2929
Practice Address - Fax:806-885-2933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-02
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory