Basic Information
Provider Information
NPI: 1356746200
EntityType: 2
ReplacementNPI:  
OrganizationName: SUNSET LABS, LLC
LastName:  
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Credential:  
OtherOrganizationName:  
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Mailing Information
Address1: 2646 S LOOP W
Address2: SUITE 665
City: HOUSTON
State: TX
PostalCode: 770542665
CountryCode: US
TelephoneNumber: 7139737246
FaxNumber:  
Practice Location
Address1: 2646 S LOOP W
Address2: SUITE 665
City: HOUSTON
State: TX
PostalCode: 770542665
CountryCode: US
TelephoneNumber: 7139737246
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/04/2014
LastUpdateDate: 07/13/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: HERRERA
AuthorizedOfficialFirstName: JOE
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: AUTHORIZED REPRESENTATIVE
AuthorizedOfficialTelephone: 7139737246
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
291U00000X TXY LaboratoriesClinical Medical Laboratory 

No ID Information.


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