Provider Demographics
NPI:1558763219
Name:ANAIAH PATHOLOGY LLC
Entity Type:Organization
Organization Name:ANAIAH PATHOLOGY LLC
Other - Org Name:ANAIAH PATHOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:H
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-778-8875
Mailing Address - Street 1:1401 E RIDGE RD
Mailing Address - Street 2:SUITE F1
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1524
Mailing Address - Country:US
Mailing Address - Phone:956-627-4922
Mailing Address - Fax:956-627-4936
Practice Address - Street 1:1401 E RIDGE RD
Practice Address - Street 2:SUITE F1
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1524
Practice Address - Country:US
Practice Address - Phone:956-627-4922
Practice Address - Fax:956-627-4936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-24
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory