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General NPI Number Information
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NPI Number | 1831135383
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Entity Type | Organization
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Legal Business Name | RED RIVER VALLEY PATHOLOGY, PA
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 08/08/2023
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Provider Practice Location Address
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Address Line | 801 CLARKSVILLE ST SUITE C
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City | PARIS
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State | TX
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Zip | 75460-0217
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Country | US
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Telephone | 903-784-7210
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 100
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City | PARIS
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State | TX
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Zip | 75461-0100
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Country | US
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Telephone | 903-783-1437
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | STEPHEN WALTER
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Credential | MD
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Telephone | 903-784-7210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State |
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