Provider Demographics
NPI:1730461252
Name:NATIONAL MEDICAL LAB LLC
Entity Type:Organization
Organization Name:NATIONAL MEDICAL LAB LLC
Other - Org Name:NATIONAL HEALTH LAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FESTUS
Authorized Official - Middle Name:C
Authorized Official - Last Name:OKERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-827-9796
Mailing Address - Street 1:6550 MAPLERIDGE ST
Mailing Address - Street 2:SUITE 217
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-4600
Mailing Address - Country:US
Mailing Address - Phone:281-827-9796
Mailing Address - Fax:
Practice Address - Street 1:6550 MAPLERIDGE ST
Practice Address - Street 2:SUITE 217
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-4600
Practice Address - Country:US
Practice Address - Phone:281-827-9796
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-10
Last Update Date:2011-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory