MEDICARE: ADG HOUSTON PATH PLLC

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician

General Provider Information

NPI Number	:	1659617009
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADG HOUSTON PATH PLLC

Provider Business Mailing Address
First Line	:	2525 W BELLFORT AVE STE 194
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-5099
Country	:	US
Telephone Number	:	281-661-1825
Fax Number	:	281-661-7569

Provider Business Practice Location Address
First Line	:	2525 W BELLFORT AVE STE 194
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-5099
Country	:	US
Telephone Number	:	281-661-1825
Fax Number	:	281-661-7569

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JARYD STEIN
Credential	:	MD
Telephone Number	:	213-392-4976

Provider Enumeration Date	:	12/12/2012
Last Update Date	:	07/09/2023

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