Provider Demographics
NPI:1437162302
Name:ACCUTOX, INC.
Entity Type:Organization
Organization Name:ACCUTOX, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING - CREDENTIALING SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:
Authorized Official - Last Name:FONTENOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-813-2228
Mailing Address - Street 1:105 IH 10 S
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-2551
Mailing Address - Country:US
Mailing Address - Phone:409-813-2228
Mailing Address - Fax:409-813-1106
Practice Address - Street 1:105 IH 10 S
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-2551
Practice Address - Country:US
Practice Address - Phone:409-813-2228
Practice Address - Fax:409-813-1106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45D0999705291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX157824701Medicaid