Organization
PULMONARY LABORATORY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH NIXON (BILLING MANAGER)
(214) 520-5743
Entity
Organization
Contact information
Practice address
1441 N BECKLEY AVE, DALLAS, TX 75203-1201
(214) 941-1366
(214) 942-5983
Mailing address
4040 N CENTRAL EXPY STE 600, DALLAS, TX 75204-3147
(214) 520-5743
(214) 520-5786
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
081936901
—
TX
01
—
895586
BLUE CROSS/BLUE SHIELD
TX
Enumeration date
08/04/2006
Last updated
06/24/2010
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