Provider Demographics
NPI:1467946848
Name:ALPHADERA LABS,LLC
Entity Type:Organization
Organization Name:ALPHADERA LABS,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HEINDEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ADU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-685-8500
Mailing Address - Street 1:15355 VANTAGE PKWY W STE 195
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77032-1965
Mailing Address - Country:US
Mailing Address - Phone:832-685-8500
Mailing Address - Fax:832-532-6003
Practice Address - Street 1:15355 VANTAGE PKWY W STE 195
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77032-1965
Practice Address - Country:US
Practice Address - Phone:832-685-8500
Practice Address - Fax:832-532-6003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-19
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory