Provider Demographics
NPI:1124312061
Name:AUSTIN PATHOLOGY ASSOCIATES
Entity type:Organization
Organization Name:AUSTIN PATHOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:C
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-324-7516
Mailing Address - Street 1:8085 RIVERS AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9239
Mailing Address - Country:US
Mailing Address - Phone:843-569-4076
Mailing Address - Fax:770-666-9464
Practice Address - Street 1:1122 AUSTIN HWY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-4844
Practice Address - Country:US
Practice Address - Phone:210-342-6488
Practice Address - Fax:210-342-6725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathologyGroup - Multi-Specialty