Provider Demographics
NPI:1265017743
Name:SOUTHERN HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:SOUTHERN HEALTHCARE SERVICES LLC
Other - Org Name:TEXAS LAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SYED
Authorized Official - Middle Name:
Authorized Official - Last Name:RIZVI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-684-3014
Mailing Address - Street 1:9100 SOUTHWEST FWY STE 114
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1523
Mailing Address - Country:US
Mailing Address - Phone:713-684-3014
Mailing Address - Fax:
Practice Address - Street 1:9100 SOUTHWEST FWY STE 114
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1523
Practice Address - Country:US
Practice Address - Phone:314-737-1914
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-16
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty