Provider Demographics
NPI:1932707619
Name:IV THERAPY, PHLEBOTOMY, SPECIMEN COLLECTION SERVICES, LLC
Entity type:Organization
Organization Name:IV THERAPY, PHLEBOTOMY, SPECIMEN COLLECTION SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PEARL
Authorized Official - Middle Name:N
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-293-7388
Mailing Address - Street 1:3845 CYPRESS CREEK PKWY STE 252
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77068-3575
Mailing Address - Country:US
Mailing Address - Phone:214-293-7388
Mailing Address - Fax:
Practice Address - Street 1:3845 CYPRESS CREEK PKWY STE 252
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77068-3575
Practice Address - Country:US
Practice Address - Phone:214-293-7388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-14
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty
No251F00000XAgenciesHome InfusionGroup - Multi-Specialty
No174200000XOther Service ProvidersMealsGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No331L00000XSuppliersBlood Bank
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332U00000XSuppliersHome Delivered Meals
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle