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General NPI Number Information
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NPI Number | 1730151317
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Entity Type | Organization
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Legal Business Name | AMERIPATH TEXAS, INC.
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Dates
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Enumeration Date | 02/07/2006
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 2501 S STATE HIGHWAY 121 BUS STE 1210
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City | LEWISVILLE
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State | TX
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Zip | 75067-4394
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Country | US
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Telephone | 972-891-3777
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Fax |
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Provider Business Mailing Address
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Address Line | 14275 MIDWAY RD SUITE 400
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City | ADDISON
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State | TX
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Zip | 75001-3614
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Country | US
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Telephone | 972-934-4300
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Fax | 972-455-1212
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DARREN THOMAS WHEELER
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Credential |
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Telephone | 702-733-7866
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 45D1066386
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License Number State | TX
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