Provider Demographics
NPI:1336431212
Name:PATHOLOGY HEALTH ASSOCIATES OF TEXAS
Entity type:Organization
Organization Name:PATHOLOGY HEALTH ASSOCIATES OF TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF MEDICAL OFFICER-CMO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ROBLES
Authorized Official - Last Name:ROBLES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:214-755-3351
Mailing Address - Street 1:2201 MOCKINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022-7891
Mailing Address - Country:US
Mailing Address - Phone:214-755-3351
Mailing Address - Fax:
Practice Address - Street 1:2201 MOCKINGBIRD LN
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-7891
Practice Address - Country:US
Practice Address - Phone:214-755-3351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory