Organization
IMMEDIATE PHLEBOTOMY SERVICE
Active
Other names
I.P.S
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY MARC PETTY CERT. PHLEBOTOMIST (C.E.O)
(832) 794-7175
Entity
Organization
Contact information
Practice address
2002 S MASON RD, 1027, KATY, TX 77450-5924
(832) 794-7175
Mailing address
2002 S MASON RD, 1027, KATY, TX 77450-5924
(832) 794-7175
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
200310R11
MD
Other
Enumeration date
11/01/2012
Last updated
11/01/2012
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