Individual
JAMES VERSALOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
6621 FANNIN ST, HOUSTON, TX 77030-2399
(832) 824-1866
(832) 825-1032
Mailing address
PO BOX 741169, HOUSTON, TX 77274-1169
(832) 824-1866
(832) 825-1032
Taxonomy
Speciality
Code
Description
License number
State
207ZP0007X
Molecular Genetic Pathology (Pathology) Physician
L4157
TX
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
L4157
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154157501
—
TX
01
—
154157502
CIDC
TX
Enumeration date
05/31/2006
Last updated
12/19/2007
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