Provider Demographics
NPI:1669434866
Name:DSHS GENETIC SERVICES
Entity type:Organization
Organization Name:DSHS GENETIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL GENETICIST
Authorized Official - Prefix:
Authorized Official - First Name:LESLEY
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:DRUMMOND-BORG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-458-7111
Mailing Address - Street 1:1100 W 49TH ST
Mailing Address - Street 2:MC 1918, ROOM M-555
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-3101
Mailing Address - Country:US
Mailing Address - Phone:512-458-7111
Mailing Address - Fax:512-458-7593
Practice Address - Street 1:401 E FRANKLIN AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79901-1206
Practice Address - Country:US
Practice Address - Phone:915-834-7745
Practice Address - Fax:915-834-7804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4908261QG0250X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QG0250XAmbulatory Health Care FacilitiesClinic/CenterGenetics