Provider Demographics
NPI:1790848968
Name:BERNSTEIN ASSOCIATED MANAGEMENT,LLC
Entity Type:Organization
Organization Name:BERNSTEIN ASSOCIATED MANAGEMENT,LLC
Other - Org Name:LOCKWOOD MEDICAL LABORATORY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BENNIE
Authorized Official - Middle Name:FERRELL
Authorized Official - Last Name:RUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:713-670-0975
Mailing Address - Street 1:4315 LOCKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77026-4117
Mailing Address - Country:US
Mailing Address - Phone:713-670-0975
Mailing Address - Fax:713-670-0998
Practice Address - Street 1:4315 LOCKWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77026-4117
Practice Address - Country:US
Practice Address - Phone:713-670-0975
Practice Address - Fax:713-670-0998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45DO970553291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXCLIA 45DO970553OtherMEDICAL LOBORATORY
TXLOCL84288Medicaid
TXCLIA 45DO970553OtherMEDICAL LOBORATORY