Provider Demographics
NPI:1659617009
Name:ADG HOUSTON PATH PLLC
Entity Type:Organization
Organization Name:ADG HOUSTON PATH PLLC
Other - Org Name:ADG HOUSTON PATH MEDICAL GROUP
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JARYD
Authorized Official - Middle Name:
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:213-392-4976
Mailing Address - Street 1:2525 W BELLFORT AVE STE 194
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-5099
Mailing Address - Country:US
Mailing Address - Phone:281-661-1825
Mailing Address - Fax:281-661-7569
Practice Address - Street 1:2525 W BELLFORT AVE STE 194
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-5099
Practice Address - Country:US
Practice Address - Phone:281-661-1825
Practice Address - Fax:281-661-7569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-12
Last Update Date:2023-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Multi-Specialty