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Organization
IRVING LABORATORIES PA
Active
Organization
IRVING LABORATORIES PA
Active
Other names
Irving Laboratories Inc
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES BELTON KETCHERSID MD (PRESIDENT)
(972) 579-8291
Entity
Organization
Contact information
Practice address
1901 N MACARTHUR BLVD, IRVING, TX 75061
(972) 271-9805
(972) 840-2884
Mailing address
PO BOX 201624, DALLAS, TX 75320-1624
(972) 271-9805
(972) 840-2884
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BB07
BLUE CROSS
TX
Enumeration date
07/08/2006
Last updated
08/22/2020
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