Provider Demographics
NPI:1821379983
Name:CLEBURNE PATHOLOGY, PA
Entity Type:Organization
Organization Name:CLEBURNE PATHOLOGY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BORKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-537-7336
Mailing Address - Street 1:201 WALLS DR
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-4007
Mailing Address - Country:US
Mailing Address - Phone:469-537-7336
Mailing Address - Fax:469-537-7339
Practice Address - Street 1:201 WALLS DR
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-4007
Practice Address - Country:US
Practice Address - Phone:713-481-3568
Practice Address - Fax:713-432-0221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-02
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2813291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory