Provider Demographics
NPI:1265662522
Name:CYTOLOGY ASSOCIATES OF HOUSTON
Entity Type:Organization
Organization Name:CYTOLOGY ASSOCIATES OF HOUSTON
Other - Org Name:GCC LABORATORY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:P
Authorized Official - Last Name:BARTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-946-2163
Mailing Address - Street 1:1611 N SAN FERNANDO BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91504-4152
Mailing Address - Country:US
Mailing Address - Phone:310-946-2163
Mailing Address - Fax:
Practice Address - Street 1:633 AERICK ST
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-1902
Practice Address - Country:US
Practice Address - Phone:310-946-2163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA05D1078088291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory