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General NPI Number Information
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NPI Number | 1992766356
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Entity Type | Organization
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Legal Business Name | NORTH TEXAS PATHOLOGY ASSOC., PA
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Dates
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Enumeration Date | 03/28/2006
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 3150 HORIZON RD
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City | ROCKWALL
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State | TX
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Zip | 75032-7805
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Country | US
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Telephone | 972-526-0340
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Fax | 972-996-1857
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Provider Business Mailing Address
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Address Line | PO BOX 226
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City | ROWLETT
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State | TX
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Zip | 75030-0226
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Country | US
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Telephone | 972-526-0340
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Fax | 972-996-1857
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHARLES EDWARD MANGUM
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Credential | MD
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Telephone | 972-526-0342
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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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