Provider Demographics
NPI:1851391924
Name:PATHOLOGY SERVICES OF TEXARKANA,LLP
Entity Type:Organization
Organization Name:PATHOLOGY SERVICES OF TEXARKANA,LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:ENGLISH
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:903-798-7124
Mailing Address - Street 1:1002 TEXAS BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75501-5117
Mailing Address - Country:US
Mailing Address - Phone:903-798-7124
Mailing Address - Fax:903-793-2332
Practice Address - Street 1:1002 TEXAS BLVD STE 500
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75501-5117
Practice Address - Country:US
Practice Address - Phone:903-792-1331
Practice Address - Fax:903-793-2332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-29
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45D0482320291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXCL8319Medicare PIN