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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