Provider Demographics
NPI:1841388527
Name:SIRUIUS PA
Entity Type:Organization
Organization Name:SIRUIUS PA
Other - Org Name:TEJAS PATHOLOGY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ZIRL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-401-7617
Mailing Address - Street 1:PO BOX 1568
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-1568
Mailing Address - Country:US
Mailing Address - Phone:281-357-4409
Mailing Address - Fax:281-255-4461
Practice Address - Street 1:605 HOLDERRIETH BLVD
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-6445
Practice Address - Country:US
Practice Address - Phone:281-401-7617
Practice Address - Fax:281-255-3431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX085703901Medicaid
TX085703901Medicaid