Provider Demographics
NPI:1659332666
Name:SURGICAL PATHOLOGISTS OF DALLAS
Entity Type:Organization
Organization Name:SURGICAL PATHOLOGISTS OF DALLAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ASSAD
Authorized Official - Middle Name:JOE
Authorized Official - Last Name:SAAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-947-3500
Mailing Address - Street 1:PO BOX 740968
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75374-0968
Mailing Address - Country:US
Mailing Address - Phone:214-947-3500
Mailing Address - Fax:
Practice Address - Street 1:221 W COLORADO
Practice Address - Street 2:STE 218
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208
Practice Address - Country:US
Practice Address - Phone:214-947-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-29
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXCP8919Medicare PIN
TXCL0551Medicare PIN