Provider Demographics
NPI:1891796256
Name:DOCTORS GENERAL LABORATORY
Entity Type:Organization
Organization Name:DOCTORS GENERAL LABORATORY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:WEINER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-996-0900
Mailing Address - Street 1:12501 HYMEADOW DR
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-2263
Mailing Address - Country:US
Mailing Address - Phone:512-996-0900
Mailing Address - Fax:512-692-4596
Practice Address - Street 1:12501 HYMEADOW DR
Practice Address - Street 2:SUITE 2B
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-2263
Practice Address - Country:US
Practice Address - Phone:512-996-0900
Practice Address - Fax:512-692-4596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-09
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
No291U00000XLaboratoriesClinical Medical Laboratory