Provider Demographics
NPI:1457606808
Name:PHYSICIANS AND ALLIED HEALTH PROFESSIONALS GROUP, PA
Entity Type:Organization
Organization Name:PHYSICIANS AND ALLIED HEALTH PROFESSIONALS GROUP, PA
Other - Org Name:THE LAB CONNECTION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CLAY
Authorized Official - Middle Name:M
Authorized Official - Last Name:HEIGHTEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-739-3757
Mailing Address - Street 1:1626 MEDICAL CENTER DR
Mailing Address - Street 2:400
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-5010
Mailing Address - Country:US
Mailing Address - Phone:915-521-8620
Mailing Address - Fax:915-546-9800
Practice Address - Street 1:1900 N OREGON ST
Practice Address - Street 2:STE 500
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3351
Practice Address - Country:US
Practice Address - Phone:915-521-8620
Practice Address - Fax:915-546-9800
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHYSICIANS AND ALLIED HEALTH PROFESSIONALS GROUP, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-07-20
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory