Provider Demographics
NPI:1992766356
Name:NORTH TEXAS PATHOLOGY ASSOC., PA
Entity type:Organization
Organization Name:NORTH TEXAS PATHOLOGY ASSOC., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLIENT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-594-3700
Mailing Address - Street 1:PO BOX 226
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75030-0226
Mailing Address - Country:US
Mailing Address - Phone:972-526-0340
Mailing Address - Fax:972-996-1857
Practice Address - Street 1:6800 SCENIC DR
Practice Address - Street 2:
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088-4552
Practice Address - Country:US
Practice Address - Phone:972-526-0340
Practice Address - Fax:972-996-1857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX181651401Medicaid
TXDE4781OtherRAILROAD MEDICARE
TX0018NDOtherBLUE CROSS AND BLUE SHIELD
TXDE4781OtherRAILROAD MEDICARE