Provider Demographics
NPI:1366589541
Name:EZEKIEL RC & PFT SERVICES
Entity type:Organization
Organization Name:EZEKIEL RC & PFT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LIVINGSTON
Authorized Official - Middle Name:S
Authorized Official - Last Name:EZEKIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-865-4960
Mailing Address - Street 1:2814 BARREL OAK ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1701
Mailing Address - Country:US
Mailing Address - Phone:210-865-4960
Mailing Address - Fax:210-614-2278
Practice Address - Street 1:2727 BABCOCK RD
Practice Address - Street 2:SUITE A
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4815
Practice Address - Country:US
Practice Address - Phone:210-614-6000
Practice Address - Fax:210-614-7728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory