Provider Demographics
NPI:1104969435
Name:BIO-SERVICES INC
Entity type:Organization
Organization Name:BIO-SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:URI
Authorized Official - Middle Name:L
Authorized Official - Last Name:GONIK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:361-575-5021
Mailing Address - Street 1:1001 E AIRLINE RD
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-4031
Mailing Address - Country:US
Mailing Address - Phone:361-575-5021
Mailing Address - Fax:361-575-0623
Practice Address - Street 1:1001 E AIRLINE RD
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-4031
Practice Address - Country:US
Practice Address - Phone:361-575-5021
Practice Address - Fax:361-575-0623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX085330102Medicaid
TX00T62EOtherBCBS
TX00T62EMedicare ID - Type Unspecified