Provider Demographics
NPI:1891379020
Name:THE PERFECT DRAW MOBILE LABORATORY SERVICE LLC
Entity Type:Organization
Organization Name:THE PERFECT DRAW MOBILE LABORATORY SERVICE LLC
Other - Org Name:PERFECT DRAW MOBILE LABS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:RASHIEDA
Authorized Official - Middle Name:D
Authorized Official - Last Name:HOLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:PBT
Authorized Official - Phone:832-278-0911
Mailing Address - Street 1:PO BOX 79522
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77279-9522
Mailing Address - Country:US
Mailing Address - Phone:832-278-0911
Mailing Address - Fax:
Practice Address - Street 1:12803 SUNSET DUNE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-5321
Practice Address - Country:US
Practice Address - Phone:832-278-0911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-12
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty
No246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical LaboratoryGroup - Single Specialty