MEDICARE: DR. MICHAEL LAPOSATA MD, PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0105X	Clinical Pathology/Laboratory Medicine Physician	MD43161	TN
2	207ZP0105X	Clinical Pathology/Laboratory Medicine Physician	71383	MA
3	207ZP0105X	Clinical Pathology/Laboratory Medicine Physician	Q8737	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	071383	OTHER	MA	TUFTS HEALTH PLAN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	J09465	OTHER	MA	BCBS MA

General Provider Information

NPI Number	:	1114999133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL LAPOSATA MD, PHD

Provider Business Mailing Address
First Line	:	PO BOX 650859
Second Line	:	DEPT 710
City	:	DALLAS
State	:	TX
Zip	:	75265-0859
Country	:	US
Telephone Number	:	409-772-2222
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 UNIVERSITY BLVD
Second Line	:
City	:	GALVESTON
State	:	TX
Zip	:	77555-0001
Country	:	US
Telephone Number	:	409-772-1011
Fax Number	:	409-772-2500

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	07/29/2021

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