Provider Demographics
NPI:1720498876
Name:LOTUS LABS
Entity Type:Organization
Organization Name:LOTUS LABS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAB MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BIBY
Authorized Official - Middle Name:ANCY
Authorized Official - Last Name:KURIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-518-7178
Mailing Address - Street 1:1735 KELLER SPRINGS SUITE #210
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006
Mailing Address - Country:US
Mailing Address - Phone:972-242-5227
Mailing Address - Fax:972-242-5229
Practice Address - Street 1:1735 KELLER SPRINGS RD STE 210
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-3014
Practice Address - Country:US
Practice Address - Phone:972-242-5227
Practice Address - Fax:972-242-5229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45D2072552291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory