Healthcare Provider Details

I. General information

NPI: 1659332666
Provider Name (Legal Business Name): SURGICAL PATHOLOGISTS OF DALLAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 12/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 W COLORADO STE 218
DALLAS TX
75208
US

IV. Provider business mailing address

PO BOX 740968
DALLAS TX
75374-0968
US

V. Phone/Fax

Practice location:
  • Phone: 214-947-3500
  • Fax:
Mailing address:
  • Phone: 214-947-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: ASSAD JOE SAAD
Title or Position: PRESIDENT
Credential: MD
Phone: 214-947-3500