Provider Demographics
NPI:1992390959
Name:BIOEXCEL DIAGNOSTICS
Entity type:Organization
Organization Name:BIOEXCEL DIAGNOSTICS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LAB DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MEHDI
Authorized Official - Middle Name:
Authorized Official - Last Name:DEHGHANI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:832-425-5042
Mailing Address - Street 1:2636 S LOOP W STE 110
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2680
Mailing Address - Country:US
Mailing Address - Phone:832-425-5042
Mailing Address - Fax:
Practice Address - Street 1:2636 S LOOP W STE 110
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2680
Practice Address - Country:US
Practice Address - Phone:832-425-5042
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-02
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory