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NPI Code Detail

MEDICARE: PROGRESSIVE PATHOLOGY INC.

MEDICARE: PROGRESSIVE PATHOLOGY INC.
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
1291U00000XClinical Medical Laboratory45D1080602TX

General Provider Information

NPI Number : 1801068671
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROGRESSIVE PATHOLOGY INC.
Provider Business Mailing Address
First Line : 530 SAN PEDRO AVE STE 102
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78212-5006
Country : US
Telephone Number : 210-499-5570
Fax Number : 210-499-5575
Provider Business Practice Location Address
First Line : 530 SAN PEDRO AVE STE 102
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78212-5006
Country : US
Telephone Number : 210-499-5570
Fax Number : 210-499-5575
Authorized Official
Title or Position : PRES
Name : MR. JAMES F FORD JR.
Credential :
Telephone Number : 210-499-5570
Provider Enumeration Date : 04/01/2008
Last Update Date : 06/20/2008

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Directions to “PROGRESSIVE PATHOLOGY INC. ” Practice Location

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