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General NPI Number Information
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NPI Number | 1396622627
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Entity Type | Organization
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Legal Business Name | ALPHA GI PATHOLOGY PLLC
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Dates
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Enumeration Date | 08/19/2025
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 902 PRESKITT RD STE 300
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City | DECATUR
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State | TX
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Zip | 76234-4124
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Country | US
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Telephone | 940-626-1864
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Fax | 940-626-1865
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Provider Business Mailing Address
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Address Line | 902 PRESKITT RD STE 300
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City | DECATUR
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State | TX
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Zip | 76234-4124
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Country | US
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Telephone | 940-626-1864
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Fax | 940-626-1865
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | GHULAM ILYAS
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Credential | MD
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Telephone | 214-550-3895
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number |
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License Number State |
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