Provider Demographics
NPI:1851467724
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:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:W
Authorized Official - Last Name:ENGLIS
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:903-798-7124
Mailing Address - Street 1:PO BOX 1888
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75403
Mailing Address - Country:US
Mailing Address - Phone:903-798-7124
Mailing Address - Fax:903-798-7196
Practice Address - Street 1:1000 PINE STREET
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75501-5100
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:2006-11-24
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Multi-Specialty
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX080055901Medicaid