Provider Demographics
NPI:1205018298
Name:DALLAS PATHOLOGY LABORATORIES, LLC
Entity Type:Organization
Organization Name:DALLAS PATHOLOGY LABORATORIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:YAN
Authorized Official - Middle Name:HILEL
Authorized Official - Last Name:LEMESHEV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-698-2488
Mailing Address - Street 1:3500 INTERSTATE 30 AT MOTLEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75185-2640
Mailing Address - Country:US
Mailing Address - Phone:972-698-2488
Mailing Address - Fax:972-698-2835
Practice Address - Street 1:3500 INTERSTATE 30 AT MOTLEY DRIVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75185-2640
Practice Address - Country:US
Practice Address - Phone:972-698-2488
Practice Address - Fax:972-698-2835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-30
Last Update Date:2007-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory