Organization
MEDI-LAB PROVIDER SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA SELENE PEREZ (ADMINISTRATOR)
(956) 360-7889
Entity
Organization
Contact information
Practice address
1307 S 10TH ST STE 2, MCALLEN, TX 78501-5023
(956) 800-5008
Mailing address
605 S 10TH ST STE B, MCALLEN, TX 78501-4967
(956) 800-5008
(956) 800-5311
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174013288
—
TX
Enumeration date
05/14/2018
Last updated
02/09/2022
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