Provider Demographics
NPI:1457381352
Name:LABORATORY PHYSICIANS ASSOCIATION
Entity type:Organization
Organization Name:LABORATORY PHYSICIANS ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RANDOLPH
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:LESTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-947-3500
Mailing Address - Street 1:PO BOX 740968
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75374-0968
Mailing Address - Country:US
Mailing Address - Phone:214-947-3500
Mailing Address - Fax:
Practice Address - Street 1:1441 NORTH BECKLEY AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75203-1201
Practice Address - Country:US
Practice Address - Phone:214-947-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
No331L00000XSuppliersBlood BankGroup - Single Specialty
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathologyGroup - Single Specialty
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXCP2070Medicare PIN
TX00PM76Medicare PIN