Provider Demographics
NPI:1417447483
Name:E SQUARED PATHOLOGY PLLC
Entity Type:Organization
Organization Name:E SQUARED PATHOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHUKWUEMEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:ETUFUGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-594-6792
Mailing Address - Street 1:1001 BUCKINGHAM RD STE 200
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-5800
Mailing Address - Country:US
Mailing Address - Phone:646-594-6792
Mailing Address - Fax:
Practice Address - Street 1:1001 BUCKINGHAM RD STE 200
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-5800
Practice Address - Country:US
Practice Address - Phone:646-594-6792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN6285207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty