Provider Demographics
NPI:1063707743
Name:UNITED TOXICOLOGY,LLC
Entity type:Organization
Organization Name:UNITED TOXICOLOGY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-432-6551
Mailing Address - Street 1:5710 LBJ FREEWAY
Mailing Address - Street 2:325
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240
Mailing Address - Country:US
Mailing Address - Phone:972-432-6551
Mailing Address - Fax:214-276-1359
Practice Address - Street 1:5710 LBJ FREEWAY
Practice Address - Street 2:215
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6398
Practice Address - Country:US
Practice Address - Phone:972-432-6551
Practice Address - Fax:214-276-1359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-10
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45D2023963291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory