Provider Demographics
NPI:1881670271
Name:WASHINGTON, LABARON THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:LABARON
Middle Name:THOMAS
Last Name:WASHINGTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 FM 1960 RD W
Mailing Address - Street 2:STE. 206
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-3405
Mailing Address - Country:US
Mailing Address - Phone:281-880-6991
Mailing Address - Fax:281-880-9664
Practice Address - Street 1:710 FM 1960 RD W
Practice Address - Street 2:MEDICAL MALL 3
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-3420
Practice Address - Country:US
Practice Address - Phone:281-440-2829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9565207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX170342301Medicaid
TXH56480Medicare UPIN
TX8C9767Medicare ID - Type UnspecifiedTRAILBLAZER