Provider Demographics
NPI:1912654096
Name:TEXAS CLINICAL LAB
Entity Type:Organization
Organization Name:TEXAS CLINICAL LAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SANAMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-677-8401
Mailing Address - Street 1:9888 BISSONNET ST STE 610
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8298
Mailing Address - Country:US
Mailing Address - Phone:832-677-8401
Mailing Address - Fax:346-204-5927
Practice Address - Street 1:9888 BISSONNET ST STE 610
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8298
Practice Address - Country:US
Practice Address - Phone:832-677-8401
Practice Address - Fax:346-204-5927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory