Provider Demographics
NPI:1841524907
Name:BIOTECH CLINICAL ANALYSTS
Entity type:Organization
Organization Name:BIOTECH CLINICAL ANALYSTS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/LAB DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BEDAR
Authorized Official - Middle Name:STEPHANE
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:MT/HEW/USAR
Authorized Official - Phone:214-650-6161
Mailing Address - Street 1:1116 BREVITO DR
Mailing Address - Street 2:STE. B
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-7124
Mailing Address - Country:US
Mailing Address - Phone:888-737-7559
Mailing Address - Fax:866-362-0116
Practice Address - Street 1:1116 BREVITO DR
Practice Address - Street 2:STE. B
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-7124
Practice Address - Country:US
Practice Address - Phone:888-737-7559
Practice Address - Fax:866-362-0116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-22
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21645291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory